Publications by authors named "Damini Tandon"

5 Publications

  • Page 1 of 1

Assessing Clinical Outcomes in Autologous Fat Grafting: A Current Literature Review.

Aesthet Surg J 2021 05;41(Suppl 1):S50-S60

Department of Surgery, Division of Plastic and Reconstructive Surgery, Barnes Jewish Hospital, Washington University, St. Louis, MO, USA.

Autologous fat grafting, first described in the 1890s, has since undergone many modifications to optimize safety and efficacy. These changes have resulted in the technique that we now consider standard of care, one that is applied to reconstruction and cosmetic enhancement of the breast and the face both independently and in conjunction with surgical treatment. There is a growing body of evidence that this application has positive outcomes for patient satisfaction, surgeon satisfaction, and overall aesthetic appearance. This article summarizes the body of literature regarding these outcomes, reviews complications of fat grafting in the face and breast, and discusses controversies including radiologic imaging changes and longevity of grafting. Level of Evidence: 4.
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http://dx.doi.org/10.1093/asj/sjab148DOI Listing
May 2021

Use of Ballistocardiography to Monitor Cardiovascular Hemodynamics in Preeclampsia.

Womens Health Rep (New Rochelle) 2021 20;2(1):97-105. Epub 2021 Apr 20.

Division of Cardiology, Department of Internal Medicine, University of California San Francisco, San Francisco, California, USA.

Pregnancy requires a complex physiological adaptation of the maternal cardiovascular system, which is disrupted in women with pregnancies complicated by preeclampsia, putting them at higher risk of future cardiovascular events. The measurement of body movements in response to cardiac ejection ballistocardiogram (BCG) can be used to assess cardiovascular hemodynamics noninvasively in women with preeclampsia. Using a previously validated, modified weighing scale for assessment of cardiovascular hemodynamics through measurement of BCG and electrocardiogram (ECG) signals, we collected serial measurements throughout pregnancy and postpartum and analyzed data in 30 women with preeclampsia and 23 normotensive controls. Using BCG and ECG signals, we extracted measures of cardiac output, J-wave amplitude × heart rate (J-amp × HR). Mixed-effect models with repeated measures were used to compare J-amp × HRs between groups at different time points in pregnancy and postpartum. In normotensive controls, the J-amp × HR was significantly lower early postpartum (E-PP) compared with the second trimester (T2;  = 0.016) and third trimester (T3;  = 0.001). Women with preeclampsia had a significantly lower J-amp × HR compared with normotensive controls during the first trimester (T1;  = 0.026). In the preeclampsia group, there was a trend toward an increase in J-amp × HR from T1 to T2 and then a drop in J-amp × HR at T3 and further drop at E-PP. We observe cardiac hemodynamic changes consistent with those reported using well-validated tools. In pregnancies complicated by preeclampsia, the maximal force of contraction is lower, suggesting lower cardiac output and a trend in hemodynamics consistent with the hyperdynamic disease model of preeclampsia.
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http://dx.doi.org/10.1089/whr.2020.0127DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8080913PMC
April 2021

Morphologic Severity of Craniosynostosis: Implications for Speech and Neurodevelopment.

Cleft Palate Craniofac J 2021 Jan 20:1055665620984643. Epub 2021 Jan 20.

Division of Plastic and Reconstructive Surgery, Washington University in St. Louis, MO, USA.

Background: Single-suture craniosynostosis (SSC) can be associated with neurodevelopmental deficits. We examined the correlation between morphologic severity and incidence of speech-language or psychological concerns.

Methods: In 62 patients (33 sagittal, 17 metopic, and 12 unicoronal), morphologic severity was determined via preoperative computed tomography (CT). Severity metrics for sagittal, metopic, and unicoronal synostosis were adjusted cephalic index (aCI), interfrontal angle (IFA), and anterior cranial fossa area ratio (ACFR), respectively. Speech-language and psychological concerns were assessed at age ≥4.5 years and defined as recommendation for therapy or monitoring.

Results: Mean assessment age was 5.7 years; 32% had a speech-language concern and 44% had a psychological concern; 44% had neither. Sagittal: Mean aCI of those with a speech-language concern (0.62) and those without (0.62) were equivalent ( = .580), as were mean aCI of those with a psychological concern (0.62) and those without (0.62; = .572). Metopic: Mean IFA with (117.9) and without (125.2) a speech-language concern were equivalent ( = .326), as were mean IFA with (120.2) and without (123.2) a psychological concern ( = .711). Unicoronal: Mean ACFR with (0.65) and without (0.69) a psychological concern ( = .423) were equivalent. However, mean ACFR with (0.74) and without (0.63) a speech-language concern were not ( = .022*). Bivariate rank correlation showed significant association between morphologic severity and speech-language score only for unicoronal synostosis (ρ = .722; = .008*).

Conclusion: A significant portion of patients with SSC had speech-language or psychological concerns. We found no correlation between morphologic severity and incidence of speech-language or psychological concerns for patients with sagittal or metopic synostosis. Morphological severity did correlate with speech concerns in patients with unicoronal synostosis.
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http://dx.doi.org/10.1177/1055665620984643DOI Listing
January 2021

Accuracy and Usability of a Self-Administered 6-Minute Walk Test Smartphone Application.

Circ Heart Fail 2015 Sep 17;8(5):905-13. Epub 2015 Aug 17.

From the Department of Medicine, Division of Cardiology (G.C.B., S.I., D.T., G.M.M., J.E.O.), and Department of Epidemiology and Biostatistics (E.V., M.J.P.), University of California San Francisco; Azumio Inc, San Francisco, CA (P.K.); and School of Public Health, Division of Community Heath and Human Development, University of California Berkeley, (K.A.M.).

Background: The 6-minute walk test (6MWT) independently predicts congestive heart failure severity, death, and heart failure hospitalizations, but must be administered in clinic by qualified staff on a premeasured course. As part of the Health eHeart Study, we sought to develop and validate a self-administered 6MWT mobile application (SA-6MWTapp) for independent use at home by patients.

Methods And Results: We performed a validation study of an SA-6MWTapp in 103 participants. In phase 1 (n=52), we developed a distance-estimation algorithm for the SA-6MWTapp by comparing step counts from an Actigraph and measured distance on a premeasured 6MWT course with step counts and estimated distance obtained simultaneously from our SA-6MWTapp (best estimation algorithm, r=0.89 [95% confidence interval 0.78-0.99]). In phase 2, 32 participants (including those with congestive heart failure and pulmonary hypertension) used the SA-6MWTapp independently in clinic, and the distance estimated by the SA-6MWTapp was compared with the measured distance (r=0.83 [95% confidence interval 0.79-0.92]). In phase 3, 19 patients with congestive heart failure and pulmonary hypertension consecutively enrolled from clinic performed 3.2±1 SA-6MWTapp tests per week at home over 2 weeks. Distances estimated from the SA-6MWTapp during home 6MWTs were highly repeatable (coefficient of variation =4.6%) and correlated with in-clinic-measured distance (r=0.88 [95% confidence interval 0.87-0.89]). Usability surveys performed during the second (in-clinic) and third (at-home) phases demonstrated that the SA-6MWTapp was simple and easy to use independently.

Conclusions: An SA-6MWTapp is easy to use and yields accurate repeatable measurements in the clinic and at home.
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http://dx.doi.org/10.1161/CIRCHEARTFAILURE.115.002062DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4843495PMC
September 2015

Presence of septal Q waves in a patient with WPW and manifest preexcitation.

Ann Noninvasive Electrocardiol 2015 May 30;20(3):296-8. Epub 2014 Sep 30.

Section of Electrophysiology, Division of Cardiology, Department of Medicine, University of California, San Francisco, CA.

Wolff-Parkinson-White syndrome (WPW) is characteristically diagnosed by the presence of a short PR interval, a delta wave, and a wide QRS wave on the surface ECG. In the absence of these clear criteria, absent septal Q waves have been used as additional evidence suggestive of subtle preexcitation. We report a patient with WPW and manifest anteroseptal (AS) accessory pathway who had prominent septal Q waves on the surface ECG. This case highlights that physicians should be careful not to dismiss preexcitation in the presence of septal Q waves.
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http://dx.doi.org/10.1111/anec.12211DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6931527PMC
May 2015