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Individual and societal impact of hypersomnolence

Chapter by: Pillai, M. V.; Lee-Chiong, T.
in: Encyclopedia of Sleep and Circadian Rhythms: Volume 1-6, Second Edition by
[S.l.] : Elsevier, 2023
pp. 466-469
ISBN: 9780323910941
CID: 5461392

Neurologic and Thrombotic Complications in the Setting of Chronic Nitrous Oxide Abuse

Meier, E; Malviya, M; Kaur, S; Ibrahim, J; Corrigan, A; Moawad, A; Bukkuri, S A; Trebach, J; Su, M K; Pillai, M
Nitrous oxide is a commonly used inhaled anesthetic for medical procedures, as well as a drug of abuse throughout the world. Excessive nitrous oxide inhalation has been shown to cause a functional vitamin B12 deficiency and hyperhomocysteinemia, which can lead to peripheral neuropathy and hypercoagulability, respectively. While the development of neurologic toxicity from chronic nitrous oxide abuse (i.e., encephalopathy, myelopathy, and neuropathy) has been previously described, the thrombotic potential of chronic nitrous oxide abuse is less known. The authors report two cases of nitrous oxide abuse leading to both neurologic and thrombotic complications.
Copyright
EMBASE:2022338744
ISSN: 1687-9635
CID: 5510062

Outcomes after long-term mechanical ventilation of cancer patients

Haviland, Kelly; Tan, Kay See; Schwenk, Nadja; Pillai, Manju V; Stover, Diane E; Downey, Robert J
BACKGROUND:The probability of weaning and of long-term survival of chronically mechanically ventilated cancer patients is unknown, with incomplete information available to guide therapeutic decisions. We sought to determine the probability of weaning and overall survival of cancer patients requiring long-term mechanical ventilation in a specialized weaning unit. METHODS:A single-institution retrospective review of patients requiring mechanical ventilation outside of a critical care setting from 2008 to 2012 and from January 1 to December 31, 2018, was performed. Demographic and clinical data were recorded, including cancer specifics, comorbidities, treatments, and outcomes. Overall survival was determined using the Kaplan-Meier approach. Time to weaning was analyzed using the cumulative incidence function, with death considered a competing risk. Prognostic factors were evaluated for use in prospective evaluations of weaning protocols. RESULTS:Between 2008 and 2012, 122 patients required mechanical ventilation outside of a critical care setting with weaning as a goal of care. The cumulative incidence of weaning after discharge from the intensive care unit was 42% at 21 days, 49% at 30 days, 58% at 60 days, 61% at 90 days, and 61% at 120 days. The median survival was 0.16 years (95% CI, 0.12 to 0.33) for those not weaned and 1.05 years (95% CI, 0.60 to 1.34) for those weaned. Overall survival at 1 year and 2 years was 52 and 32% among those weaned and 16 and 9% among those not weaned. During 2018, 36 patients at our institution required mechanical ventilation outside of a critical care setting, with weaning as a goal of care. Overall, with a median follow-up of 140 days (range, 0-425 days; average, 141 days), 25% of patients requiring long-term mechanical ventilation (9 of 36) are alive. CONCLUSIONS:Cancer patients can be weaned from long-term mechanical ventilation, even after prolonged periods of support. Implementation of a resource-intensive weaning program did not improve rates of successful weaning. No clear time on mechanical ventilation could be identified beyond which weaning was unprecedented. Short-term overall survival for these patients is poor.
PMCID:7106688
PMID: 32228554
ISSN: 1472-684x
CID: 4458182

Pulmonary toxicity

Chapter by: Pillai, Manju
in: DeVita, Hellman, and Rosenberg's cancer : principles & practice of oncology by DeVita, Vincent T; Lawrence, Theodore S; Rosenberg, Steven A (Eds)
Philadelphia : Wolters Kluwer, copyright 2019
pp. ?-?
ISBN: 1496394631
CID: 3799542

CPAP AND BILATERAL PERIORBITAL EDEMA: A CASE REPORT [Meeting Abstract]

Lixon, A.; Pillai, M.; Abdulfattah, O.; Weinstein, M.
ISI:000471071004099
ISSN: 0161-8105
CID: 4458292

A Case of Unilateral Pleural Effusion with Large Thyroid Mass [Meeting Abstract]

Reid, E.; Pillai, M.
ISI:000466771103518
ISSN: 1073-449x
CID: 4458302

CENTRAL SLEEP APNEA FROM ANTI-HU ANTI-BODY ENCEPHALITIS [Meeting Abstract]

Mehta, Vishisht; Pillai, Manju
ISI:000455041400936
ISSN: 0012-3692
CID: 4458192

Rasburicase Induced Methemoglobinemia in a Patient with G6PD Deficiency- A Review of Pathophysiology and Treatment Considerations [Meeting Abstract]

Makkar, P.; Pillai, M. V.; Mehta, V.
ISI:000449978901362
ISSN: 1073-449x
CID: 4458202

Relapsing Pulmonary Nocardiosis From Various Species Within a Single Host [Meeting Abstract]

Gupta, Karan; Pillai, Manju
ISI:000418374000108
ISSN: 0012-3692
CID: 3534762

A Troubling Trifecta: Pulmonary Alveolar Proteinosis and Pneumocystis Pneumonia in Acute Myeloid Leukemia [Meeting Abstract]

Patel, Priya; Lee, Robert; Pillai, Manju; Stover, Diane
ISI:000400118600130
ISSN: 0012-3692
CID: 3534752