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Your search keyword '"Kedar, Archana"' showing total 117 results
Start Over Author "Kedar, Archana" Publication Type Academic Journals
117 results on '"Kedar, Archana"'

5. Opioid Use and Potency Are Associated With Clinical Features, Quality of Life, and Use of Resources in Patients With Gastroparesis

Author

Pasricha, Pankaj Jay, Clarke, John, Kim, Yale, Nguyen, Linda, Ullah, Nighat, Snape, William, DeVole, Nata, Greene, Mary, Lee, Candice, Ponsetto, Courtney, Shetler, Katerina, Parkman, Henry P., Kantor, Steven, Lytes, Vanessa, Palit, Amiya, Simmons, Kellie, McCallum, Richard W., Hejazi, Reza, Roeser, Kathy, Sarosiek, Irene, Vasquez, Denise, Vega, Natalia, Abell, Thomas, Beatty, Karen, Hatter, Lisa, Howard, Ronna, Nowotny, Lindsay, Tang, Shou, Amin, Om S., Henry, Olivia, Kedar, Archana, McNair, Valerie, Pruett, Susanne, Smith, Margaret, Spree, Danielle, Hasler, William, Castle, Michelle, Coleski, Radoslav, Wootten, Sophanara, Koch, Kenneth, Baxter, Lynn, Brown, Anya, Culler, Samantha, Hooker, Judy, Stuart, Paula, Farrugia, Gianrico, Grover, Madhusudan, Bernard, Cheryl, Calles-Escandon, Jorge, Serrano, Jose, Hamilton, Frank, James, Steven, Torrance, Rebecca, Van Raaphorst, Rebekah, Tonascia, James, Belt, Patricia, Hallinan, Erin Corless, Colvin, Ryan, Donithan, Michele, Green, Mika, Isaacson, Milana, Kim, Wana, Lee, Linda, May, Patrick, Miriel, Laura, Sternberg, Alice, Van Natta, Mark, Vaughn, Ivana, Wilson, Laura, Yates, Katherine, Hasler, William L., Wilson, Laura A., Nguyen, Linda A., Snape, William J., Abell, Thomas L., Koch, Kenneth L., Pasricha, Pankaj J., Lee, Linda A., and Hamilton, Frank A.

Published
2019
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8. Relating gastric scintigraphy and symptoms to motility capsule transit and pressure findings in suspected gastroparesis

Author

Hasler, W. L., May, K. P., Wilson, L. A., Van Natta, M., Parkman, H. P., Pasricha, P. J., Koch, K. L., Abell, T. L., McCallum, R. W., Nguyen, L. A., Snape, W. J., Sarosiek, I., Clarke, J. O., Farrugia, G., Calles‐Escandon, J., Grover, M., Tonascia, J., Lee, L. A., Miriel, L., Hamilton, F. A., Kim, Yale, Ullah, Nighat, DeVole, Nata, Greene, Mary, Lee, Candice, Ponsetto, Courtney, Shetler, Katerina, Kantor, Steven, Lytes, Vanessa, Palit, Amiya, Simmons, Kellie, Hejazi, Reza, Roeser, Kathy, Vasquez, Denise, Vega, Natalia, Beatty, Karen, Hatter, Lisa, Howard, Ronna, Nowotny, Lindsay, Tang, Shou, Amin, Om S, Henry, Olivia, Kedar, Archana, McNair, Valerie, Pruett, Susanne, Smith, Margaret, Spree, Danielle, Castle, Michelle, Coleski, Radoslav, Wootten, Sophanara, Baxter, Lynn, Brown, Anya, Culler, Samantha, Hooker, Judy, Stuart, Paula, Bernard, Cheryl, Lurken, Matthew, Serrano, Jose, James, Steven, Torrance, Rebecca, Van Raaphorst, Rebekah, Belt, Patricia, Hallinan, Erin Corless, Colvin, Ryan, Donithan, Michele, Green, Mika, Isaacson, Milana, Kim, Wana, Sternberg, Alice, Vaughn, Ivana, and Yates, Katherine

Published
2018
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13. Advances in the management of atrial fibrillation with a special focus on non-pharmacological approaches to prevent thromboembolism: a review of current recommendations.

Author

Riddle, Malini, McCallum, Richard, Ojha, Chandra Prakash, Paul, Timir Kumar, Gupta, Vineet, Baran, David Alan, Prakash, Bharat Ved, Misra, Amogh, Mares, Adriana Camila, Abedin, Moeen, Kedar, Archana, Mulukutla, Venkatachalam, Ibrahim, Ahmed, and Nagarajarao, Harsha

Abstract

Atrial fibrillation (AFIB) is the most common heart rhythm abnormality and is associated with significant morbidity and mortality. While the treatment of AFIB involves strategies of rate with or without rhythm control, it is also essential to strategize appropriate therapies to prevent thromboembolic complications arising from AFIB. Previously, anticoagulation was the main treatment option which exposed patients to higher than usual risk of bleeding. However, with the advent of new technology, novel therapeutic options aimed at surgical or percutaneous exclusion or occlusion of the left atrial appendage in preventing thromboembolic complications from AFIB have evolved. This review evaluates recent advances and therapeutic options in treating AFIB with a special focus on both surgical and percutaneous interventions which can reduce and/or eliminate thromboembolic complications of AFIB. [ABSTRACT FROM AUTHOR]

Published
2020
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19. Gastric Electrical Stimulation Is an Option for Patients with Refractory Cyclic Vomiting Syndrome.

Author

Grover, Inderpreet, Kim, Richard, Spree, Danielle C., Lahr, Christopher J., Kedar, Archana, Kothari, Shivangi, Fleisher, David, and Abell, Thomas L.

Subjects
VOMITING treatment, NAUSEA treatment, GASTROINTESTINAL disease treatment, GASTROPARESIS, QUALITY of life, THERAPEUTICS
Abstract

Background/Aims Cyclic vomiting syndrome (CVS) is a disabling migraine variant manifesting as severe episodes of nausea and vomiting and often refractory to many therapies. Gastric electrical stimulation (GES), which can reduce nausea and vomiting in gastroparesis, may provide symptomatic relief for drug-refractory CVS. This study assessed the utility GES in reducing the symptoms of CVS and improving the quality of life. Methods A one-year, non-randomized, clinical study was conducted. Eleven consecutive patients with drug refractory, cyclic vomiting syndrome based on Rome III criteria and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN), underwent treatment with temporary GES (Temp GES) and permanent GES (Perm GES). Post-treatment follow up was done up to one year after permanent gastric electrical stimulation therapy. Results Total symptom score decreased by 68% and 40% after temporary and permanent GES therapies, respectively. Hospital admission events significantly decreased to 1.50 (± 1.00) events from 9.14 (± 7.21) annual admissions prior to treatment with permanent GES. Vomiting episodes fell by 83% post Temp GES and 69% after Perm GES treatments. Mucosal electrogram values also changed after temporary stimulation. Conclusions In a small group of drug-refractory CVS patients, treatments with temporary and permanent GES significantly reduced the severity of gastrointestinal symptoms and frequency of hospital admissions. [ABSTRACT FROM AUTHOR]

Published
2016
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20. Twenty-five years of advocacy for patients with gastroparesis: support group therapy and patient reported outcome tool development.

Author

Cutts, Teresa, Holmes, Sandra, Kedar, Archana, Beatty, Karen, Mohammad, Mohammad K., Abell, Thomas, and K Mohammad, Mohammad

Subjects
GASTROPARESIS, GASTROINTESTINAL disease treatment, GASTROINTESTINAL diseases, SYMPTOMS, QUALITY of life, PATIENTS, THERAPEUTICS, PHYSIOLOGY
Abstract

Background: Gastroparesis (Gp) is a poorly understood chronic gastrointestinal medical condition for which patient reported outcomes (PRO) are lacking. Previously developed symptoms scoring has been used for several decades. Using symptoms scores as a basis for documentation, 12 years of support/focus group patient feedback from the nearly 1000 attendees were integrated with medical care and recommendations for treatment were developed. Early attenders of the support group were compared with non-attendees for illness acuity, disability, and duration and number of office phone calls. Methods: Patients cared for in an academic medical practice were assessed for patient-derived PRO symptoms, coupled with standardized Health Related Quality of Life (HRQOL) measures. Based on factors identified by the patients via support/focus groups, a diagnostic and prognostic tool was developed. Results: The new tool utilized PRO symptoms and included provider assessments of medical illnesses as well as resource utilization. This 'post PRO' tool has been applied in a variety of settings for patients with the symptoms of Gp over the last two decades. The 'pre-PRO' factors from the support/focus groups were compared to the PRO measures as well as the 'post-PRO' scale to assess their usefulness. Using methods that combine chart data, including electronic medical records (EMR), with PRO symptoms may have design implications for PRO assessment. The resultant scales, as part of a new tool, can allow for sharing of PRO derived scores in a chronic gastrointestinal (GI), illness with different practitioners. Conclusions: These newly-derived scales offer a potentially useful tool for clinical decision-making, tailoring treatment to patient subgroups and engaging both patients and their families and caregivers in more active partnerships with providers to improve health outcomes. [ABSTRACT FROM AUTHOR]

Published
2016
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21. Long-term outcomes of gastric electrical stimulation in children with gastroparesis.

Author

Islam, Saleem, McLaughlin, Jillian, Pierson, Justine, Jolley, Christopher, Kedar, Archana, and Abell, Thomas

Abstract

Background Gastric electrical stimulation (GES) has been used in adults with gastroparesis. However its use has been limited in children. We describe the largest experience with GES in children with long-term outcomes. Methods Data were collected on children who underwent GES over a 10-year period. Data regarding demographics, medical history, hospital course, and outcomes were collected and analyzed. Symptom scores (validated Likert scores) were compared using a paired Student's t test. Results Overall, 97 patients underwent GES, and a majority were teenage Caucasian girls. Ninety-six had temporary GES (tGES), and 66 had improvement in their symptoms. A total of 67 underwent permanent implantation (pGES), and there was significant reduction in all individual symptoms ( p < 0.001) as well as the total symptom score (TSS) ( p < 0.0001) at 1, 6, 12, and > 12 months. Recurrence of symptoms leading to device removal occurred in 7 cases. Forty-one patients had continued improvement in symptoms for over 12 months, with a mean follow-up of 3.5 years (range 1–9 years). Conclusions This study represents the largest experience of systematic application of GES in children. GES is a safe and effective therapy for selected children with intractable GP with continued symptomatic improvement at 1 year and beyond. [ABSTRACT FROM AUTHOR]

Published
2016
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22. Temporary Endoscopic Stimulation in Gastroparesis-like Syndrome.

Author

Singh, Sanjeev, McCrary, Jeff, Kedar, Archana, Weeks, Stephen, Beauerle, Brian, Weeks, Andrew, Endashaw, Omer, Lahr, Chris, Starkebaum, Warren, and Abell, Thomas

Subjects
GASTROPARESIS, ENDOSCOPY, ELECTRIC stimulation, GASTRIC emptying, NAUSEA, VOMITING
Abstract

Background/Aims Gastroparesis-like syndrome (GLS) is defined as gastroparesis-like symptoms with normal gastric scintigraphy. While the efficacy of gastric electrical stimulation (GES) in gastroparesis is well known, the utility of GES in GLS is largely unknown. Our aim was to clarify the role of GES in GLS. We implanted consecutive patients with symptoms of gastroparesis with temporary gastric electrical stimulation and observed changes in gastric scintigraphy and total symptom score. Methods Five hundred and fifty-one patients suffering from symptoms of gastroparesis (nausea, vomiting, bloating/distension, anorexia/ early satiety, and abdominal pain) with negative endoscopy underwent gastric scintigraphy with analysis of 1) solid radionuclide gastric emptying at 1, 2, and 4 hours (% remaining); 2) area under the gastric emptying curve (AUC) at 1, 2, and 4 hours; and 3) total gastric emptying test (GET) (the sum of 1, 2, and 4 hour values). Patients were stratified into: delayed gastric emptying, normal gastric emptying, and rapid gastric emptying (Appendix). Of the 551 patients in the larger cohort, 379 had implantation of temporary gastric electrical stimulation (tGES). Gastrointestinal symptoms and gastric emptying were com - pared pre and post tGES implantation. Results After tGES, 2 hour gastric retention decreased (P < 0.01) for the delayed patients, and increased (P< 0.001) for normal and rapid patients. These changes were accompanied by improvements (P< 0.001) in vomiting, nausea, and total symptom scores in all 3 subgroups. Conclusions Gastric electrical stimulation may be an effective therapy for treating the symptoms of gastroparesis with normal gastric emptying. Further exploration of endoscopic electrical stimulation as a treatment for gastroparesis-like symptoms with non-delayed gastric emptying is needed. [ABSTRACT FROM AUTHOR]

Published
2015
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39. Gastroparesis syndromes: Response to electrical stimulation.

Author

Abell, Thomas L., Kedar, Archana, Stocker, Abigail, Beatty, Karen, McElmurray, Lindsay, Hughes, Michael, Rashed, Hani, Kennedy, William, Wendelschafer‐Crabb, Gwen, Yang, Xiu, Fraig, Mostafa, Omer, Endashaw, Miller, Ed, Griswold, Michael, and Pinkston, Christina

Subjects
*GASTROPARESIS, *PYLORUS, *SYNDROMES, *QUALITY of life
Abstract

Background and Aims: Factors underlying gastroparesis are not well defined, nor is the mechanism of action of gastric electrical stimulation (GES). We hypothesized that GES acts via several mechanisms related to underlying disordered pathophysiology. Methods: We studied 43 consecutive eligible patients with gastroparetic symptoms, previously evaluated by two methods in each of five core areas: inflammatory, autonomic, enteric, electrophysiologic, and hormonal; and also categorized by GI symptoms, metabolic status, illness quantification, and gastric physiology. We then studied 41 patients who underwent temporary GES for 5‐7 days. Thirty‐six of those patients were implanted and 30 were followed up at 6 months after permanent GES. Results: In previous but separately reported work, patients had similar GI symptoms regardless of baseline gastric emptying or diabetic/idiopathic status and all patients demonstrated abnormalities in each of the five areas studied. After GES, patients showed early and late effects of electrical stimulation with changes noted in multiple areas, categorized by improvement status. Conclusion: Patients with symptoms of gastroparesis have multiple abnormalities, including systemic inflammation and disordered hormonal status. GES affects many of these abnormalities. We conclude electrical stimulation improves symptoms and physiology with (a) an early and sustained anti‐emetic effect; (b) an early and durable gastric prokinetic effect in delayed emptying patients; (c) an early anti‐arrhythmic effect that continues over time; (d) a late autonomic effect; (e) a late hormonal effect; (f) an early anti‐inflammatory effect that persists; and (g) an early and sustained improvement in health‐related quality of life. This study is registered with Clinicaltrials.gov under study # NCT03178370 (https://clinicaltrials.gov/ct2/show/NCT03178370). A consensus does not exist on the pathophysiologic factors underlying gastroparetic symptoms. Gastric electrical stimulation (GES) has early and late effects on disordered physiology in gastroparetic symptom patients. Gastric electrical stimulation might better be classified as neuromodulation due to its several possible mechanisms of action. [ABSTRACT FROM AUTHOR]

Published
2019
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