Puneet Shroff

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Scholarly Contributions

Chapters

• Shroff, P., & Alschuler, L. N. (2022). Integrative Medicine and Immune Support. In Rakel Integrative Medicine(p. 27).
• Shroff, P., & Alschuler, L. N. (2022). Integrative Medicine and Immune Support. In Rakel Integrative Medicine(p. 8). Elsevier.
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  An authorative textbook and reference book on integrative medicine for healthcare practitioners. This reference book provides scientific evidence and practical guidelines for the application of integrative medicine in a condition-based format.

Journals/Publications

• Shroff, P. (2023).

  A pilot prospective longitudinal study comparing dupilumab to surgery in CRSwNP

  . Authorea. doi:10.22541/au.168568030.09343015/v1
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  Background: To date, there have not been any direct comparative studies assessing clinical outcomes in CRSwNP between biologic and surgical therapies. Objective: To directly compare the effect of dupilumab to FESS using subjective and objective outcomes of CRSwNP patients in a prospective longitudinal study. Methods: We prospectively enrolled 20 CRSwNP patients and counseled them on both biologic and surgical options. Patients were able to decide on either therapy, and data collected at baseline and 3-, 6-, 9-, and 12-months with subjective outcomes including the nasal congestion score (NCS) and SNOT-22 questionnaires, and objectively by degree of smell (UPSIT-40) and nasal polyp score (NPS). Results: All subjects met criteria for either biologic therapy or surgery, with NPS >5, Lund-Mackay score (LMK-CT)>16, SNOT-22>54, and were graded as anosmic/hyposmic. There were no significant differences in age, sex, comorbid asthma/Aspirin Exacerbated Respiratory Disease, or prior FESS between groups. Both dupilumab and FESS significantly improved outcomes by one year in patients with severe CRSwNP when compared to baseline. At one-year, patients on dupilumab had greater improvement in NCS, UPSIT and asthma control relative to one year post FESS. In a subgroup of patients with a history of prior sinus surgery and asthma, dupilumab had lower polyp recurrence rate compared to one year post FESS. Conclusions: Both dupilumab and FESS can significantly improve outcomes by one year in CRSwNP patients. However, in those with a history of asthma and prior surgery, dupilumab is more effective in reducing polyp recurrence and improving sinonasal outcomes than FESS.
• Shroff, P. (2023).

  Temporal Changes in Vaccine-Specific Willingness Across Race/Ethnicity Following Serious Adverse Event Reports

  . American Journal of Public Health. doi:10.2105/ajph.2023.307484
• Soffer, G. K., Shroff, P., & Horwitz, R. (2022). Safety Considerations for Natural Products Commonly Used By Patients with Allergic Disease. The journal of allergy and clinical immunology. In practice, 10(12), 3131-3138.
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  Natural products are a category of Complementary and Alternative Medicine that includes medicinal plants, vitamins, and dietary supplements. These products are often utilized by patients with allergies in conjunction with, or as an alternative to, their conventional medical therapies. Despite the wide use of these modalities, many clinicians often have limited knowledge and training in their use. It is important for health care providers to know the safety and risks of these products that their patients may use. This Clinical Commentary reviews the side effects and adverse reactions of several natural products commonly used by patients with allergies and gives an overview of the U.S. Food and Drug Administration requirements for manufacturing, advertising and distribution.
• Shroff, P., & Shroff, P. (2020). Wellness, Positivity, and Mental Health During the COVID-19 Pandemic. American College of Allergy, Asthma, and Immunology.
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  Integrative Medicine Committee of the ACAAI recommendations for you and your allergy and asthma patients who are stressed about COVID-19 and its impact on their chronic conditions.
• Ringold, D. A., Shroff, P., Sikka, S. K., Early, D. S., Edmundowicz, S. A., Ylagan, L. R., Jonnalagadda, S. S., & Azar, R. R. (2009). Pancreatitis is frequent among patients with side-branch intraductal papillary mucinous neoplasia diagnosed by EUS.. Gastrointestinal endoscopy, 70(3), 488-94. doi:10.1016/j.gie.2008.11.039
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  Because of greater recognition and improved imaging capabilities, intraductal papillary mucinous neoplasms (IPMNs) are being diagnosed with increasing frequency. IPMNs of the main pancreatic duct cause symptoms and lead to pancreatitis. Side-branch (SB) IPMNs are thought to cause symptoms less frequently, and their association with pancreatitis is not well defined..Our purpose was to ascertain whether an association exists between SB-IPMN and pancreatitis..Single-center, retrospective study..Academic medical center..A total of 305 patients underwent EUS examinations between October 2002 and October 2006 for pancreatic cystic lesions..The main outcome measure was the frequency of acute or chronic pancreatitis that was not procedurally related..Thirty-two patients had SB-IPMNs, and 11 (34%) had pancreatitis. Three patients reported a single episode, and 8 patients reported having recurrent episodes of pancreatitis. Overall, 17 (53%) patients had symptoms possibly attributable to SB-IPMN. Female sex (73% vs 38%) and multiple pancreatic lesions (54% vs 24%) were more commonly seen in those with pancreatitis, but were not statistically significant factors. Larger cyst size or cyst fluid marker levels did not appear associated with pancreatitis occurrence. EUS-FNA demonstrated communication with the pancreatic duct in 94% and thick, mucinous fluid in 84%..Single-center, retrospective study..Pancreatitis was frequently associated with the presence of SB-IPMNs in our referral practice. SB-IPMNs should be considered in the differential diagnosis of patients with recurrent pancreatitis with cystic lesions seen on imaging studies. EUS-FNA was the most useful modality in helping to differentiate SB-IPMNs from other lesions.

Presentations

• Shroff, P. (2022).

  Biologics for Asthma

  . Advanced Respiratory Medicine Block, Pulmonary Fellowship Training Program,University of Arizona College of Medicine, Tucson.
• Shroff, P. (2022).

  Case Presentations [Sinusitis] – Surgery or Biology and Why?

  . Invited Discussant, ENT in the Desert 2022. Tucson, AZ, Loews Ventana Canyon Meeting Room: University of Arizona Department of Otolaryngology, Tucson, AZ.
• Shroff, P. (2022).

  Overview of Integrative Medicine

  . Internal Medicine Resident ConferenceUniversity of Arizona College of Medicine, Tucson, Department of Medicine.
• Shroff, P. (2022).

  “Multi-Disciplinary Type 2 Airway"

  . ENT in the Desert 2022, Invited Discussant. Tucson, AZ: University of Arizona Department of Otolaryngology.
• Shroff, P. (2022). Idiopathic Anaphylaxis. Ambulatory Rotation Elective, Banner University MedicineAmbulatory Rotation Elective, Banner University Medicine, University of Arizona College of Medicine, Tucson, AZ.
• Shroff, P. (2022). Resilience for Health Care Professionals. Internal Medicine Resident ConferenceUniversity of Arizona College of Medicine, Tucson, AZ.
• Shroff, P., & Wu, C. (2022).

  In-Person Interesting Case Workshop: “Eczema Herpeticum, A Challenging Diagnosis in an Adult with Recurrent Shingles Outbreaks”

  . 2022 Annual Meeting of Academy of Allergy, Asthma and Immunology, Phoenix Convention Center. Phoenix, AZ, Phoenix Convention Center - AAAAI National Meeting: American Academy of Allergy, Asthma, & Immunology.
• Shroff, P. (2021).

  “Evidence-Based Integrative Medicine in Allergy & Immunology” 

  . Invited Speaker/Discussant 2021 Annual Meeting of American College of Allergy, Asthma, & Immunology. New Orleans, LA Convention Center: American College of Allergy, Asthma & Immunology.
• Shroff, P. (2021). Integrative Approaches for Allergic Rhinitis and Sinusitis. Invited Speaker, Academy of Integrative Health and Medicine - Chapter Meeting. Tucson, AZ: Academy of Integrative Health and Medicine.
• Shroff, P. (2021, March).

  Integrative Approaches to Allergic Rhinitis and Asthma

  . Invited Speaker, Integrative Medicine Elective for Residency. Tucson, Arizona: Andrew Weil Center for Integrative Medicine, University of Arizona, Tucson, AZ.
• Shroff, P. (2021, March). Mind-Body Approaches to Rhinitis, Sinusitis, and Asthma. Invited Speaker, Integrative Medicine Elective for Residency. University of Arizona, Tucson, AZ: Andrew Weil Center for Integrative Medicine.
• Shroff, P. (2020, January). Comprehensive Management of Chronic Sinusitis with Nasal Polyps. ENT in the Desert 2020. University of Arizona Health Sciences, Tucson AZ.
• Shroff, P. (2019, November). New Horizons in Chronic Rhinisinusitis. 2019 Annual Meeting of American College of Allergy, Asthma, & Immunology. Houston, Texas: American College of Allergy, Asthma & Immunology (ACAAI).
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  This session will review our understanding of nasal polyps and discuss the medical and surgical management of specific endotypes, with a focus on biologic therapies.Moderator for Session at Annual Meeting of American College of Allergy, Asthma & Immunology- Developed and oversaw relevant topic and curriculum materials- Oversaw program and led session at National meeting- Maintenance of Certification designated activity with real-time questions to support participant learning