Search

Your search keyword '"Kedar, Archana"' showing total 43 results
Start Over Author "Kedar, Archana" Publisher elsevier b.v.
43 results on '"Kedar, Archana"'

3. 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
Full Text
View/download PDF

6. Long-Term Effects of Gastric Stimulation on Gastric Electrical Physiology.

Author

Williams, Patrick, Nikitina, Yana, Kedar, Archana, Lahr, Christopher, Helling, Thomas, and Abell, Thomas

Subjects
ELECTROGASTROGRAPHY, ELECTRIC stimulation, GASTROPARESIS, GASTROINTESTINAL motility, STOMACH physiology, GASTROINTESTINAL diseases
Abstract

Introduction: This study evaluates the modeling of gastric electrophysiology tracings during long-term gastric electrical stimulation for gastroparesis. We hypothesized that serosal electrogastrogram may change over time representing gastric remodeling from gastric stimulation. Patients: Sixty-five patients with gastroparesis underwent placement of gastric stimulator for refractory symptoms. Mean age at initial stimulator placement was 44 years (range, 8-76), current mean age was 49, and the majority of the subjects were female ( n = 51, 78 %). Only a minority had diabetes-induced gastroparesis ( n = 16, 25 %); the remainder were either idiopathic or postsurgical. Methods: At the time of stimulator placement, electrogastrogram was performed after the gastric leads were placed but before stimulation was begun. Patients underwent continuous stimulation until pacer batteries depleted. At the time of replacement, before the new pacemaker was attached, electrogastrogram was again performed. Results: After a mean of 3.9 years of stimulation therapy, the mean of baseline frequency before stimulation therapy was 5.06 cycles/min and declined to 3.66 after replacement ( p = 0.0000002). The mean amplitude was 0.33 mV before stimulation therapy and decreased to 0.31 mV ( p = 0.73). The frequency/amplitude ratio was 38.4 before stimulation therapy and decreased to 21.9 ( p = 0.001). Conclusion: Long-term gastric electrical stimulation causes improvement in basal unstimulated gastric frequency to near normal. [ABSTRACT FROM AUTHOR]

Published
2013
Full Text
View/download PDF

22. Mo1288 Intra-Operative Electrophysiological and Interstitial Cell of Cajal Findings in Patients With the Symptoms of Gastroparesis.

Author

Kedar, Archana, Abell, Thomas L., Bernard, Cheryl E., Farrugia, Gianrico, Lahr, Christopher J., Hasler, William L., Koch, Kenneth L., McCallum, Richard W., Nguyen, Linda Anh B., Parkman, Henry P., Pasricha, Pankaj J., Sarosiek, Irene, Snape, William J., Unalp, Aynur, Tonascia, James, Serrano, Jose, and Hamilton, Frank A.

Published
2014
Full Text
View/download PDF

31. A double-masked, randomized, placebo-controlled trial of temporary endoscopic mucosal gastric electrical stimulation for gastroparesis.

Author

Abell, Thomas L., Johnson, William D., Kedar, Archana, Runnels, J. Matthew, Thompson, Janelle, Weeks, Ernest S., Minocha, Anil, and Griswold, Michael E.

Abstract

Background: Endoscopically placed, temporary gastric electrical stimulation (tGES) may relieve symptoms of gastroparesis (Gp) and predict permanent gastric electrical stimulation (GES) outcomes. Objective: To measure effects of 72 hours of temporary GES on Gp symptoms. Design, Setting, and Patients: From 2005 to 2006, we conducted a hospital-based, randomized, placebo-controlled, crossover trial of two consecutive, 4-day sessions (session 1 and session 2), enrolling 58 patients (11 males, 47 females; mean age 46 years) with GP symptom histories of three etiologies (idiopathic, 38; diabetes mellitus, 13; postsurgical, 7). Intervention: 72 continuous hours temporary GES was provided for group A during session 1, and for group B during session 2. Main Outcome Measurements: Symptoms measured daily; gastric emptying, electrogastrography, and quality of life measured at baseline and session close. Results: In session 1, vomiting decreased in both groups, but was greater with stimulation, resulting in a day 3 difference of −1.02 (95% CI, −1.62 to −0.42; P < .001). Scores did not return to baseline during washout; on day 4, the difference persisted at −1.08 (95% CI, −1.81 to −0.35; P = .005). In session 2, vomiting slightly decreased with stimulation and slightly increased without it; at day 8, the nonactivated group had nonsignificantly greater vomiting, 0.12 (−0.68 to 0.92; P = .762). An overall treatment effect of a slight, nonsignificant daily decrease in average vomiting scores, −0.12 (−0.26 to 0.03; P = .116), was observed by pooling stimulation effects across sessions. Limitations: Missing data; potential physiological imbalances between groups. Conclusions: Although overall treatment effects were not significant, differences in favor of stimulation were suggested. Barriers to observing treatment effects included a decrease in vomiting for both groups during session 1, insufficient washout, and the absence of baseline vomiting for some patients. Future studies should better define inclusion criteria, use longer washout periods, randomize by etiology and baseline physiological findings, and pursue alternative designs. (Clinical trial registration number: 00432835.) [Copyright &y& Elsevier]

Published
2011
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results