Manish Joshi

• University of Petroleum and Energy Studies

Background and Purpose In the ESCAPE-NA1 (Efficacy and Safety of Nerinetide for the Treatment of Acute Ischaemic Stroke) trial, treatment with nerinetide was associated with improved outcomes in patients who did not receive intravenous alteplase. We compared the effect of nerinetide on clinical outcomes in patients without concurrent intravenous al...

BACKGROUND In the ESCAPE-NA1 trial (Efficacy and Safety of Nerinetide for the Treatment of Acute Ischemic Stroke), treatment with nerinetide was associated with a smaller infarct volume among patients who did not receive intravenous alteplase. We assessed the effect of nerinetide on the surrogate imaging outcome of final infarct volume in patients...

Purpose of review To present an overview of the impact of climate change upon human respiratory health. Recent findings Climate change is directly impacting air quality. Particulate matter clearly increases mortality rates. Ozone, a longstanding suspect in climate-related injury, turns out not to have the major impact that had been projected at cu...

Background and Purpose Infarct volume and other imaging markers are increasingly used as surrogate measures for clinical outcome in acute ischemic stroke research, but how improvements in these imaging surrogates translate into better clinical outcomes is currently unclear. We investigated how changes in infarct volume at 24 hours alter the probabi...

BACKGROUND To assess the association of qualitative and quantitative infarct characteristics and 3 cognitive outcome tests, namely the Montreal Cognitive Assessment (MOCA) for mild cognitive impairment, the Boston Naming Test for visual confrontation naming, and the Sunnybrook Neglect Assessment Procedure for neglect, in large vessel occlusion stro...

Introduction Seroprevalence surveys can estimate the cumulative incidence of SARS-CoV-2 infection in a symptom-independent manner, offering valuable data, including herd immunity, that can inform national and local public health policies. To our knowledge, there have been no large studies reporting seroprevalence in healthcare workers (HCWs) in the...

Background and Purpose: Human papillomavirus-associated oropharyngeal squamous cell carcinoma (OPSCC) is increasingly prevalent. Despite the overall more favorable outcome, the observed heterogeneous treatment response within this patient group highlights the need for additional means to prognosticate and guide clinical decision-making. Promising p...

Human beings have used marijuana products for centuries. Relatively recent data showing extensive cannabinoid receptors, particularly in the brain, help to explain the impacts of cannabinoids on symptoms/diseases, such as pain and seizures, with major nervous system components. Marijuana can cause bronchitis, but a moderate body of literature sugge...

Background First‐pass effect (FPE), that is, achieving reperfusion with a single thrombectomy device pass, is associated with better clinical outcomes in patients with acute stroke. FPE is therefore increasingly used as a marker of device and procedural efficacy. We aimed to evaluate the ability of thrombus‐based radiomics models to predict FPE in...

Purpose CT angiography (CTA) is the imaging standard for large vessel occlusion (LVO) detection in patients with acute ischemic stroke. StrokeSENS LVO is an automated tool that utilizes a machine learning algorithm to identify anterior large vessel occlusions (LVO) on CTA. The aim of this study was to test the algorithm’s performance in LVO detecti...

Background Successful reperfusion determines the treatment effect of endovascular thrombectomy. We evaluated stent-retriever characteristics and their relation to reperfusion in the ESCAPE-NA1 trial. Methods Independent re-scoring of reperfusion grade for each attempt was conducted. The following characteristics were evaluated: stent-retriever len...

Purpose of review: To review recent data on the microbiome of the lungs and how it changes with the evolution of COPD. To explore initial data with respect to COPD and the gut-lung axis. An expanded understanding of the pathogenesis of COPD may lead to new therapeutic targets. Recent findings: Intermittent pulmonary seeding is essential to healt...

Background The DAWN and DEFUSE-3 trials showed the benefit of endovascular treatment (EVT) in acute ischemic stroke patients presenting beyond 6 hours from last known well (LKW) and selected by perfusion imaging criteria. The ESCAPE NA1-trial selected patients based on non-contrast CT (NCCT) Alberta Stroke Program Early CT Score (ASPECTS) and multi...

PurposeThere are few data on the prevalence and impact of isolated deep grey matter infarction in acute stroke. In this study, we aimed to investigate the prevalence of isolated deep grey matter infarcts and their impact on the outcome.Methods Infarcts on 24-h follow-up imaging (non-contrast head CT or diffusion-weighted MRI) in the ESCAPE-NA1 tria...

Background Intracranial hemorrhage is a known complication after endovascular treatment in patients with acute ischemic stroke due to large vessel occlusion, but the association between radiologic hemorrhage severity and outcome is controversial. Purpose To investigate the prevalence and impact on outcome of intracranial hemorrhage and hemorrhage s...

Background The effect of infarct pattern on functional outcome in acute ischemic stroke is incompletely understood. Purpose To investigate the association of qualitative and quantitative infarct variables at 24-hour follow-up noncontrast CT and diffusion-weighted MRI with 90-day clinical outcome. Materials and Methods The Safety and Efficacy of Ner...

Background: The optimal treatment and prognosis for stroke patients with tandem cervical carotid occlusion are unclear. We analyzed outcomes and treatment strategies of tandem occlusion patients in the ESCAPE-NA1 trial. Methods: ESCAPE-NA1 was a multicenter international randomized trial of nerinetide versus placebo in 1105 patients with acute i...

Purpose: In this post-hoc analysis of the ESCAPE-NA1 trial, we investigated the prevalence of deep grey matter infarcts and their influence on clinical outcome. Methods: Infarcts on 24 hour follow up imaging (non contrast head CT or diffusion-weighted MRI) were categorized as predominantly deep grey matter infarcts (caudate and/or lentiform nucleus...

Purpose of review: To review and compare the constellations of causes and consequences of the two current pandemics, Covid-19 and climate change. Recent findings: There has been a transient counterbalancing, in which the response to Covid-19 has briefly mitigated pollution and greenhouse gasses. This divergence belies multiple commonalities of c...

Background Nerinetide, an eicosapeptide that interferes with post-synaptic density protein 95, is a neuroprotectant that is effective in preclinical stroke models of ischaemia-reperfusion. In this trial, we assessed the efficacy and safety of nerinetide in human ischaemia-reperfusion that occurs with rapid endovascular thrombectomy in patients who...

Background: Nerinetide, an eicosapeptide that interferes with post-synaptic density protein 95, is a neuroprotectant that is effective in preclinical stroke models of ischaemia-reperfusion. In this trial, we assessed the efficacy and safety of nerinetide in human ischaemia-reperfusion that occurs with rapid endovascular thrombectomy in patients wh...

Purpose of review: To present an overview of the impact of climate change upon human respiratory health. Recent findings: Climate change involves two major types of change. First, there is overall progressive warming. Second, there is increased variability/unpredictability in weather patterns. Both types of change impact negatively upon human re...

Rozlana idiopatyczna hiperplazja komórek neuroendokrynnych płuc (DIPNECH) jest rzadką chorobą, występuje najczęściej u niepalących kobiet w średnim wieku, a objawia się kaszlem, dusznością i świszczącym oddechem. Wyniki badań czynnościowych wykazują najczęściej obturację oskrzeli, zaś tomografia komputerowa (TK) klatki piersiowej zazwyczaj ujawnia...

Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare disease that is classically described as presenting with cough, dyspnea, and wheezing in non-smoker middle aged females. Pulmonary function tests commonly demonstrate an obstructive pattern and CT of chest usually reveals diffuse air trapping with mosaic pattern. We pr...

Purpose of reviewThis article examines factors associated with readmission for chronic obstructive pulmonary disease and interventions that may decrease readmissions.Recent findingsThe literature on this topic is relatively sparse. Drug therapy revolves around appropriate use of bronchodilators, antibiotics, and steroids. Patient education and part...

Introduction: Detecting distal intracranial arterial occlusion is of increasing importance as current studies begin to evaluate the potential benefit of tPA in minor acute stroke. Multiphase CTA (mCTA) is a technique used routinely at our centre in the setting of suspected acute ischemic stroke (AIS). Hypothesis: We hypothesized that mCTA is diagno...

Seasonal Influenza ("the flu") is a respiratory illness caused by influenza viruses. Yearly influenza vaccination is considered to be protective against illness and/or severity of illness and is recommended by CDC for all individuals > 6 months of age. However, the effectiveness of influenza vaccine in older individuals has come under question. To...

Chronic obstructive pulmonary disease (COPD) is a crippling disease with a high worldwide prevalence. It is the fifth-leading cause of death worldwide and estimated to become the third-leading cause of death by 2030. This review highlights recent studies that discuss reasons for and possible solutions to the delay in diagnosis of COPD. Delay in COP...

Background: Therapeutic hypothermia (TH) is recommended in international resuscitation guidelines.TH has been incorporated into the American Heart Association practice guidelines and use of TH has steadily increased, but widespread clinical uptake remains low Hypothesis: Our aim was to examine the frequency of TH use after cardiac arrest in United...

Introduction: Heart Disease and Stroke Statistics_2014 Update suggests more than 424,000 people suffer out of hospital cardiac arrest (OHCA) in the United States. Hypothesis: We assessed seasonal variation in OHCA from a large national hospitalisation database in the past decade. Methods: The Nationwide Inpatient Sample database was used to estim...

Introduction: Heart Disease and Stroke Statistics_2014 Update suggests more than 424,000 people suffer out of hospital cardiac arrest (OHCA) in the United States. Hypothesis: We assessed seasonal variation in OHCA from a large national hospitalisation database in the past decade. Methods: The Nationwide Inpatient Sample database was used to estimat...

SESSION TITLE: ICU Infections Posters SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM PURPOSE: To assess inpatient Morbidity and Mortality associated with influenza in 2013-14 Flu season in an academic tertiary care center. METHODS: We identified all patients admitted to our university me...

SESSION TITLE: Interstitial Lung Disease Cases I SESSION TYPE: Affiliate Case Report Slide PRESENTED ON: Sunday, October 26, 2014 at 03:15 PM - 04:15 PM INTRODUCTION: Super Vena Cava (SVC) Syndrome is a clinical condition that results from obstruction of blood flow in the SVC. While the majority of cases (75%) are malignancy-related, it is estimate...

SESSION TITLE: DVT/PE/Pulmonary Hypertension Posters III SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM PURPOSE: Atrial fibrillation (AF) represents a significant healthcare burden. Literature reporting the incidence and outcomes of AF in pulmonary hypertension (PH) is limited. We sought...

Rationale: IFN-γ release assays (IGRAs) including the QuantiFERON-TB gold in-tube test (QFT-GIT) are increasingly used in place of the tuberculin skin test (TST) in surveillance programs for Mycobacterium tuberculosis infection in the United States. However, data on conversions, reversions, and predictive value of QFT in such programs for health c...

Cannabis sativa (marijuana) is used throughout the world, and its use is increasing. In much of the world, marijuana is illicit. While inhalation of smoke generated by igniting dried components of the plant is the most common way marijuana is used, there is concern over potential adverse lung effects. The purpose of this review is to highlight rece...

Atypical Presentations in the ICUSESSION TYPE: Affiliate Case Report SlidePRESENTED ON: Wednesday, October 30, 2013 at 11:30 AM - 12:30 PMINTRODUCTION: Limbic encephalitis (LE) is a paraneoplastic process involving temporo-limbic structures of brain. Usually, LE presents with behavioral changes, short-term memory problems, seizures and cognitive dy...

SESSION TYPE: TB and NTMPRESENTED ON: Sunday, October 21, 2012 at 01:15 PM - 02:45 PMPURPOSE: To assess Quantiferon Gold In-Tube (QFT) assay feasibility, conversions, and reversions in US healthcare workers (HCWs) and compare it with Tuberculin skin test (TST)METHODS: We identified a HCW cohort at Central Arkansas Veterans Healthcare System (CAVHS)...

SESSION TYPE: Cancer Cases IIIPRESENTED ON: Wednesday, October 24, 2012 at 11:15 AM - 12:30 PMINTRODUCTION: Vasculitides are associated with malignancies, as a manifestation or as a paraneoplastic syndrome. However, patients with anti-neutrophil cytoplasmic antibodies (ANCA) associated vasculitis (AAV) developing malignancies is rarely reported in...

Reliable quantification of both intracerebral hemorrhage and intraventricular hemorrhage (IVH) volume is important for hemostatic trials. We evaluated the reliability of computer-assisted planimetric volume measurements of IVH. Computer-assisted planimetry was used to quantify IVH volume. Five raters measured IVH volumes, total (intracerebral hemor...

Chronic obstructive pulmonary disease (COPD) is a crippling disease with a high worldwide prevalence. The purpose of this review is to highlight recent studies which define the global impact of COPD on quality of life. There are direct implications for care. Dyspnea is a dominant and defining symptom for patients with COPD, but the overall degree o...

Interferon-gamma release assays including the QuantiFERON-TB Gold In-Tube test (QFT-GIT [Cellestis Ltd, Australia]) may be used in place of the tuberculin skin test (TST) in surveillance programs for Mycobacterium tuberculosis infection control. However, data on performance and practicality of the QFT-GIT in such programs for health care workers (H...

In a geographical area with high prevalence of calcific granulomatous inflammation, calcified lymph nodes may affect the diagnostic adequacy of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). The objective of this study was to describe the diagnostic performance of EBUS-TBNA in a region endemic of histoplasmosis relate...

To describe the use of videoconference telemedicine for providing outpatient pulmonary consultation to a remote, underserved clinic site. Analysis of data from the Milwaukee Veteran Affairs Medical Center (VAMC) pulmonary telemedicine clinic. Pulmonary physicians at the Milwaukee VAMC provide outpatient consultations with the use of videoconference...

The differential diagnosis of pulmonary nodules in a patient with HIV infection is broad, with bacterial pneumonia being the most common diagnosis.¹The CT halo sign refers to a zone of ground-glass attenuation surrounding a pulmonary nodule on CT images and is usually associated with hemorrhagic nodules.² The halo sign has been described in many in...

Primary pulmonary amyloidosis is an uncommon condition that may involve the pulmonary parenchyma or tracheobronchial tree manifested radiographically as a single nodule or multiple lung nodules. The diagnosis is confirmed by a lung biopsy that exhibits apple green birefringence under a polarized microscope after staining with Congo red dye. The cli...

Actinomycosis is most frequently caused in humans by Actinomyces israelii and the usual route of lung infection is by aspiration of oropharyngeal or gastrointestinal secretions. Endobronchial actinomycosis is a rare form of pulmonary actinomycosis most often associated with foreign body aspiration. Chouabe et al reported the largest series of endob...

One hundred and twelve cases (culture + = 107, pus = 5) of empyema were identified. The patients were predominantly men over 45 yrs of age (45-65 yrs=52%, >65yrs =42%). Most common pathogenetic factors were post pneumonic in 66(60%) and post thoracotomy in 18(16%). Sixty percent of the empyemas were community-acquired and the remaining were hospita...