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Brüggen MC, Le ST, Walsh S, Toussi A, de Prost N, Ranki A, Didona B, Colin A, Horváth B, Brezinova E, Milpied B, Moss C, Bodemer C, Meyersburg D, Salavastru C, Tiplica GS, Howard E, Bequignon E, Bouwes Bavinck JN, Newman J, Gueudry J, Nägeli M, Zaghbib K, Pallesen K, Bygum A, Joly P, Wolkenstein P, Chua SL, Le Floch R, Shear NH, Chu CY, Hama N, Abe R, Chung WH, Shiohara T, Ardern-Jones M, Romanelli P, Phillips EJ, Stern RS, Cotliar J, Micheletti RG, Brassard A, Schulz JT, Dodiuk-Gad RP, Dominguez AR, Paller AS, Seminario-Vidal L, Mostaghimi A, Noe MH, Worswick S, Tartar D, Sheridan R, Kaffenberger BH, Shinkai K, Maverakis E, French LE, Ingen-Housz-Oro S. Supportive care in the acute phase of Stevens-Johnson syndrome and toxic epidermal necrolysis: an international, multidisciplinary Delphi-based consensus. Br J Dermatol 2021; 185:616-626. [PMID: 33657677 DOI: 10.1111/bjd.19893] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Supportive care is the cornerstone of management of adult and paediatric Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). However, consensus on the modalities of supportive care is lacking. OBJECTIVES Our aim in this international multicentric Delphi exercise was to establish a multidisciplinary expert consensus to standardize recommendations regarding supportive care in the acute phase of SJS/TEN. METHODS Participants were sent a survey via the online tool SurveyMonkey, consisting of 103 statements organized into 11 topics: multidisciplinary team composition, suspect drug management, infection prevention, fluid resuscitation and prevention of hypothermia, nutritional support, pain and psychological distress management, management of acute respiratory failure, local skincare, ophthalmological management, management of other mucosa, and additional measures. Participants evaluated the level of appropriateness of each statement on a scale of 1 (extremely inappropriate) to 9 (extremely appropriate). The results were analysed according to the RAND/UCLA Appropriateness Method. RESULTS Forty-five participants from 13 countries (on three continents) participated. After the first round, a consensus was obtained for 82.5% of the 103 initially proposed statements. After the second round, a final consensus was obtained for 102 statements. CONCLUSIONS We have reached an international Delphi-based consensus on best supportive care practice for SJS/TEN. Our expert consensus should help guide physicians in treating patients with SJS/TEN and thereby improve short-term prognosis and the risk of sequelae.
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Khanna S, Newman J, Gupta A, Wen I, Bhat A, Chen H, Gan G, Tan T. Left Ventricular Global Longitudinal Strain is a Predictor of Adverse Cardiovascular Outcomes in Patients With Rheumatoid Arthritis. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Nguyen U, Tinsley B, Sen Y, Stein J, Palacios Y, Ceballos A, Welch C, Nzenkue K, Penn A, Murphy L, Leodones K, Casiquin J, Ivory I, Ghenta K, Danziger K, Widman E, Newman J, Triplehorn M, Hindi Z, Mulligan K. Exposure to bisphenol A differentially impacts neurodevelopment and behavior in Drosophila melanogaster from distinct genetic backgrounds. Neurotoxicology 2020; 82:146-157. [PMID: 33309840 DOI: 10.1016/j.neuro.2020.12.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/30/2020] [Accepted: 12/06/2020] [Indexed: 12/13/2022]
Abstract
Bisphenol A (BPA) is a ubiquitous environmental chemical that has been linked to behavioral differences in children and shown to impact critical neurodevelopmental processes in animal models. Though data is emerging, we still have an incomplete picture of how BPA disrupts neurodevelopment; in particular, how its impacts may vary across different genetic backgrounds. Given the genetic tractability of Drosophila melanogaster, they present a valuable model to address this question. Fruit flies are increasingly being used for assessment of neurotoxicants because of their relatively simple brain structure and variety of measurable behaviors. Here we investigated the neurodevelopmental impacts of BPA across two genetic strains of Drosophila-w1118 (control) and the Fragile X Syndrome (FXS) model-by examining both behavioral and neuronal phenotypes. We show that BPA induces hyperactivity in larvae, increases repetitive grooming behavior in adults, reduces courtship behavior, impairs axon guidance in the mushroom body, and disrupts neural stem cell development in the w1118 genetic strain. Remarkably, for every behavioral and neuronal phenotype examined, the impact of BPA in FXS flies was either insignificant or contrasted with the phenotypes observed in the w1118 strain. This data indicates that the neurodevelopmental impacts of BPA can vary widely depending on genetic background and suggests BPA may elicit a gene-environment interaction with Drosophila fragile X mental retardation 1 (dFmr1)-the ortholog of human FMR1, which causes Fragile X Syndrome and is associated with autism spectrum disorder.
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Etkin A, Maron-Katz A, Wu W, Fonzo GA, Huemer J, Vértes PE, Patenaude B, Richiardi J, Goodkind MS, Keller CJ, Ramos-Cejudo J, Zaiko YV, Peng KK, Shpigel E, Longwell P, Toll RT, Thompson A, Zack S, Gonzalez B, Edelstein R, Chen J, Akingbade I, Weiss E, Hart R, Mann S, Durkin K, Baete SH, Boada FE, Genfi A, Autea J, Newman J, Oathes DJ, Lindley SE, Abu-Amara D, Arnow BA, Crossley N, Hallmayer J, Fossati S, Rothbaum BO, Marmar CR, Bullmore ET, O'Hara R. Using fMRI connectivity to define a treatment-resistant form of post-traumatic stress disorder. Sci Transl Med 2020; 11:11/486/eaal3236. [PMID: 30944165 DOI: 10.1126/scitranslmed.aal3236] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 02/01/2018] [Accepted: 11/07/2018] [Indexed: 12/14/2022]
Abstract
A mechanistic understanding of the pathology of psychiatric disorders has been hampered by extensive heterogeneity in biology, symptoms, and behavior within diagnostic categories that are defined subjectively. We investigated whether leveraging individual differences in information-processing impairments in patients with post-traumatic stress disorder (PTSD) could reveal phenotypes within the disorder. We found that a subgroup of patients with PTSD from two independent cohorts displayed both aberrant functional connectivity within the ventral attention network (VAN) as revealed by functional magnetic resonance imaging (fMRI) neuroimaging and impaired verbal memory on a word list learning task. This combined phenotype was not associated with differences in symptoms or comorbidities, but nonetheless could be used to predict a poor response to psychotherapy, the best-validated treatment for PTSD. Using concurrent focal noninvasive transcranial magnetic stimulation and electroencephalography, we then identified alterations in neural signal flow in the VAN that were evoked by direct stimulation of that network. These alterations were associated with individual differences in functional fMRI connectivity within the VAN. Our findings define specific neurobiological mechanisms in a subgroup of patients with PTSD that could contribute to the poor response to psychotherapy.
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Newman J, Hussain Z, Hussain F, Poonawalla M, Bontekoe E, Basha HI, Fareed J, Heroux A, Liebo M, Walenga J, Raichlin E. Dysregulation of the Angiopoietin-2/Tie-2 Axis is Associated with Reduced Pulsatility and Increased Arteriovenous Malformation Related Gastrointestinal Bleeding Following Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Maron-Katz A, Zhang Y, Narayan M, Wu W, Toll RT, Naparstek S, De Los Angeles C, Longwell P, Shpigel E, Newman J, Abu-Amara D, Marmar C, Etkin A. Individual Patterns of Abnormality in Resting-State Functional Connectivity Reveal Two Data-Driven PTSD Subgroups. Am J Psychiatry 2020; 177:244-253. [PMID: 31838870 DOI: 10.1176/appi.ajp.2019.19010060] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE A major challenge in understanding and treating posttraumatic stress disorder (PTSD) is its clinical heterogeneity, which is likely determined by various neurobiological perturbations. This heterogeneity likely also reduces the effectiveness of standard group comparison approaches. The authors tested whether a statistical approach aimed at identifying individual-level neuroimaging abnormalities that are more prevalent in case subjects than in control subjects could reveal new clinically meaningful insights into the heterogeneity of PTSD. METHODS Resting-state functional MRI data were recorded from 87 unmedicated PTSD case subjects and 105 war zone-exposed healthy control subjects. Abnormalities were modeled using tolerance intervals, which referenced the distribution of healthy control subjects as the "normative population." Out-of-norm functional connectivity values were examined for enrichment in cases and then used in a clustering analysis to identify biologically defined PTSD subgroups based on their abnormality profiles. RESULTS The authors identified two subgroups among PTSD cases, each with a distinct pattern of functional connectivity abnormalities with respect to healthy control subjects. Subgroups differed clinically on levels of reexperiencing symptoms and improved case-control discriminability and were detectable using independently recorded resting-state EEG data. CONCLUSIONS The results provide proof of concept for the utility of abnormality-based approaches for studying heterogeneity within clinical populations. Such approaches, applied not only to neuroimaging data, may allow detection of subpopulations with distinct biological signatures so that further clinical and mechanistic investigations can be focused on more biologically homogeneous subgroups.
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Toll RT, Wu W, Naparstek S, Zhang Y, Narayan M, Patenaude B, De Los Angeles C, Sarhadi K, Anicetti N, Longwell P, Shpigel E, Wright R, Newman J, Gonzalez B, Hart R, Mann S, Abu-Amara D, Sarhadi K, Cornelssen C, Marmar C, Etkin A. An Electroencephalography Connectomic Profile of Posttraumatic Stress Disorder. Am J Psychiatry 2020; 177:233-243. [PMID: 31964161 DOI: 10.1176/appi.ajp.2019.18080911] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors sought to identify brain regions whose frequency-specific, orthogonalized resting-state EEG power envelope connectivity differs between combat veterans with posttraumatic stress disorder (PTSD) and healthy combat-exposed veterans, and to determine the behavioral correlates of connectomic differences. METHODS The authors first conducted a connectivity method validation study in healthy control subjects (N=36). They then conducted a two-site case-control study of veterans with and without PTSD who were deployed to Iraq and/or Afghanistan. Healthy individuals (N=95) and those meeting full or subthreshold criteria for PTSD (N=106) underwent 64-channel resting EEG (eyes open and closed), which was then source-localized and orthogonalized to mitigate effects of volume conduction. Correlation coefficients between band-limited source-space power envelopes of different regions of interest were then calculated and corrected for multiple comparisons. Post hoc correlations of connectomic abnormalities with clinical features and performance on cognitive tasks were conducted to investigate the relevance of the dysconnectivity findings. RESULTS Seventy-four brain region connections were significantly reduced in PTSD (all in the eyes-open condition and predominantly using the theta carrier frequency). Underconnectivity of the orbital and anterior middle frontal gyri were most prominent. Performance differences in the digit span task mapped onto connectivity between 25 of the 74 brain region pairs, including within-network connections in the dorsal attention, frontoparietal control, and ventral attention networks. CONCLUSIONS Robust PTSD-related abnormalities were evident in theta-band source-space orthogonalized power envelope connectivity, which furthermore related to cognitive deficits in these patients. These findings establish a clinically relevant connectomic profile of PTSD using a tool that facilitates the lower-cost clinical translation of network connectivity research.
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Samuelson KW, Newman J, Abu Amara D, Qian M, Li M, Schultebraucks K, Purchia E, Genfi A, Laska E, Siegel C, Hammamieh R, Gautam A, Jett M, Marmar CR. Predeployment neurocognitive functioning predicts postdeployment posttraumatic stress in Army personnel. Neuropsychology 2020; 34:276-287. [DOI: 10.1037/neu0000603] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Khanna S, Newman J, Bhat A, Chen H, Fernandez F, Gan G, Tan T. 385 Patients with Systemic Lupus Erythematosus With Normal Left Ventricular Ejection Fraction Demonstrate Impaired Left Ventricular Global Longitudinal Strain. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Rogers JH, Brandstetter E, Wolf C, Logue J, Kim AE, Newman KL, Sugg N, Gerard AM, Weis B, Fay N, Newman J, Cathey J, Englund JA, Boeckh M, Chu HY. 2318. Prevalence of Influenza-like Illness in Sheltered Homeless Populations: A Cross-Sectional Study in Seattle, WA. Open Forum Infect Dis 2019. [PMCID: PMC6810802 DOI: 10.1093/ofid/ofz360.1996] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Individuals experiencing homelessness are at an increased risk of respiratory illness due to high prevalence of underlying chronic conditions, inadequate ventilation and crowding in shelters, and difficulty accessing health services. Few studies have investigated the prevalence and transmission of viral respiratory infections within shelters. We sought to determine the prevalence and risk factors for influenza-like illness (ILI) at two homeless shelters in Seattle, WA. Methods Between January and April 2019, we conducted a cross-sectional study of adults experiencing homelessness who identified their primary residence as one of the two shelters in Seattle. Participants voluntarily enrolled if they self-reported at least two symptoms of acute respiratory illness in the past week. Demographic, clinical, and behavioral data were ascertained via questionnaire, and a mid-nasal swab was collected. ILI was defined as fever with cough or sore throat. Chronic lung disease was defined as chronic obstructive pulmonary disease, asthma, and/or chronic bronchitis. Results Among the 480 participants enrolled in the study, 204 (42.5%) reported ILI symptoms. Of those enrolled, 144 (30.0%) had chronic lung disease. The prevalence of ILI was higher among individuals with chronic lung disease (53.5% vs. 42.5%, P = 0.001). A total of 422 (87.9%) had health insurance; the prevalence of ILI was lower among those with health insurance (42.4% vs. 57.8%, P = 0.66). 216 (45.0%) of participants received flu vaccine; the prevalence of ILI was similar among those who received the vaccine than those that did not (42.6% vs. 42.4%, P = 1.00). 129 (30.6%) of those with health insurance sought care for their reported symptoms; ILI was more prevalent in those that sought care than those that did not throughout the observation period (33.8% vs. 21.7%, P = 0.002). Of those with ILI that sought care, 46 (54.8%, P = 0.42) received antivirals or antibiotics. Laboratory results for the corresponding mid-nasal swabs are pending. Conclusion A large proportion of our study population self-reported ILI and chronic lung disease. Despite high insurance coverage, a low proportion of homeless enrolled sought care for their symptoms or received treatment. ![]()
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Disclosures All authors: No reported disclosures.
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Kümin M, Deery J, Turney S, Price C, Vinayakam P, Smith A, Filippa A, Wilkinson-Guy L, Moore F, O'Sullivan M, Dunbar M, Gaylard J, Newman J, Harper CM, Minney D, Parkin C, Mew L, Pearce O, Third K, Shirley H, Reed M, Jefferies L, Hewitt-Gray J, Scarborough C, Lambert D, Jones CI, Bremner S, Fatz D, Perry N, Costa M, Scarborough M. Reducing Implant Infection in Orthopaedics (RIIiO): Results of a pilot study comparing the influence of forced air and resistive fabric warming technologies on postoperative infections following orthopaedic implant surgery. J Hosp Infect 2019; 103:412-419. [PMID: 31493477 DOI: 10.1016/j.jhin.2019.08.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 08/28/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Active warming during surgery prevents perioperative hypothermia but the effectiveness and postoperative infection rates may differ between warming technologies. AIM To establish the recruitment and data management strategies needed for a full trial comparing postoperative infection rates associated with forced air warming (FAW) versus resistive fabric warming (RFW) in patients aged >65 years undergoing hemiarthroplasty following fractured neck of femur. METHODS Participants were randomized 1:1 in permuted blocks to FAW or RFW. Hypothermia was defined as a temperature of <36°C at the end of surgery. Primary outcomes were the number of participants recruited and the number with definitive deep surgical site infections. FINDINGS A total of 515 participants were randomized at six sites over a period of 18 months. Follow-up was completed for 70.1%. Thirty-seven participants were hypothermic (7.5% in the FAW group; 9.7% in the RFW group). The mean temperatures before anaesthesia and at the end of surgery were similar. For the primary clinical outcome, there were four deep surgical site infections in the FAW group and three in the RFW group. All participants who developed a postoperative infection had antibiotic prophylaxis, a cemented prosthesis, and were operated under laminar airflow; none was hypothermic. There were no serious adverse events related to warming. CONCLUSION Surgical site infections were identified in both groups. Progression from the pilot to the full trial is possible but will need to take account of the high attrition rate.
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Al Shakarchi J, Inston N, Dabare D, Newman J, Garnham A, Hobbs S, Wall M. Pilot study on the use of infrared thermal imaging to predict infrainguinal bypass outcome in the immediate post-operative period. Vascular 2019; 27:663-667. [PMID: 31067207 DOI: 10.1177/1708538119847391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives Early bedside post-operative monitoring of infrainguinal bypass surgery is currently based on subjective clinical findings and handheld Doppler signals. Infrared thermal imaging is an objective and reproducible technique that has been proven to be a reliable and accurate method to measure skin temperature. The aim of this prospective study was to assess infrared thermal imaging as a predicting tool of bypass graft outcome in the immediate post-operative period and assess the angiosome concept. Methods This was a prospective cohort study of 25 patients undergoing infrainguinal bypass. Demographic and clinical data were prospectively collected and included gender, age, co-morbidities, pre- and post-operative ankle brachial pressure indices, surgery undertaken and patency of run-off vessels. Infrared thermal imaging was undertaken pre- and post-operatively to assess thermal changes to the feet following revascularisation. Results We found that an increase in temperature from pre- to post-operative was significantly associated with bypass patency. An increase in temperature was found to have a positive predictive value of 75%, a negative predictive value of 100%, a sensitivity of 100% and specificity of 89% for predicting graft patency. Conclusions Infrared thermal imaging can be used to measure temperature related changes of the microcirculation post-operatively and predict bypass outcomes in the immediate post-operative period.
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Hussain F, Newman J, Basha H, Morris S, Waqar A, Heroux A, McGee E, Raichlin E, Liebo M. Does Type of Mechanical Circulatory Support as Bridge to Heart Transplant Affect Outcomes? J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Newman J, Mullan C, Geib M, Stevens G, Majure D, Hussain S, Fernandez H, Hartman A, Lima B. Regional and Socioeconomic Distribution, Healthcare Utilization, and In-Hospital Mortality of Heart Transplantation. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Hernandez G, Baumann K, Knight S, Purrington H, Gilgannon M, Newman J, Tobase P, Mathew S, Cooper DL. Ranges and drivers of risk associated with sports and recreational activities in people with haemophilia: results of the Activity‐Intensity‐Risk Consensus Survey of
US
physical therapists. Haemophilia 2018; 24 Suppl 7:5-26. [DOI: 10.1111/hae.13623] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 09/27/2018] [Indexed: 11/28/2022]
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Berg K, Davis W, Sheon A, Newman J, Daprano J, Adebambo I, Einstadter D, Perzynski A. STRATEGIES FOR ADDRESSING DIGITAL LITERACY AND INTERNET ACCESS AS SOCIAL DETERMINANTS OF HEALTH. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lotan E, Morley C, Newman J, Qian M, Abu-Amara D, Marmar C, Lui YW. Prevalence of Cerebral Microhemorrhage following Chronic Blast-Related Mild Traumatic Brain Injury in Military Service Members Using Susceptibility-Weighted MRI. AJNR Am J Neuroradiol 2018; 39:1222-1225. [PMID: 29794235 PMCID: PMC7655437 DOI: 10.3174/ajnr.a5688] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 04/04/2018] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND PURPOSE Cerebral microhemorrhages are a known marker of mild traumatic brain injury. Blast-related mild traumatic brain injury relates to a propagating pressure wave, and there is evidence that the mechanism of injury in blast-related mild traumatic brain injury may be different from that in blunt head trauma. Two recent reports in mixed cohorts of blunt and blast-related traumatic brain injury in military personnel suggest that the prevalence of cerebral microhemorrhages is lower than in civilian head injury. In this study, we aimed to characterize the prevalence of cerebral microhemorrhages in military service members specifically with chronic blast-related mild traumatic brain injury. MATERIALS AND METHODS Participants were prospectively recruited and underwent 3T MR imaging. Susceptibility-weighted images were assessed by 2 neuroradiologists independently for the presence of cerebral microhemorrhages. RESULTS Our cohort included 146 veterans (132 men) who experienced remote blast-related mild traumatic brain injury (mean, 9.4 years; median, 9 years after injury). Twenty-one (14.4%) reported loss of consciousness for <30 minutes. Seventy-seven subjects (52.7%) had 1 episode of blast-related mild traumatic brain injury; 41 (28.1%) had 2 episodes; and 28 (19.2%) had >2 episodes. No cerebral microhemorrhages were identified in any subject, as opposed to the frequency of SWI-detectable cerebral microhemorrhages following blunt-related mild traumatic brain injury in the civilian population, which has been reported to be as high as 28% in the acute and subacute stages. CONCLUSIONS Our results may reflect differences in pathophysiology and the mechanism of injury between blast- and blunt-related mild traumatic brain injury. Additionally, the chronicity of injury may play a role in the detection of cerebral microhemorrhages.
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Renault O, Martinez E, Zborowski C, Mann J, Inoue R, Newman J, Watanabe K. Analysis of buried interfaces in multilayer device structures with hard XPS (HAXPES) using a CrKα source. SURF INTERFACE ANAL 2018. [DOI: 10.1002/sia.6451] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Haas K, Notay M, Rodriguez W, Rolston M, Clark A, Burney W, Newman J, Pedersen T, Crawford R, Dandekar S, Sivamani R. 383 Doxycycline effects on the gut and skin microbiomes and lipidome in acne. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Lee S, Dana A, Newman J. 574 Teledermatology as a tool for preoperative consultation prior to Mohs micrographic surgery within the Veterans Health Administration. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Money N, Newman J, Demissie S, Roth P, Blau J. Anti-microbial stewardship: antibiotic use in well-appearing term neonates born to mothers with chorioamnionitis. J Perinatol 2017; 37:1304-1309. [PMID: 28981079 DOI: 10.1038/jp.2017.137] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 07/05/2017] [Accepted: 07/18/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To determine if implementation of a protocol based on a neonatal early-onset sepsis (EOS) calculator developed by Kaiser Permanente would safely reduce antibiotic use in well-appearing term infants born to mothers with chorioamnionitis in the unique setting of an Observation Nursery. STUDY DESIGN Data obtained from a retrospective chart review of well-appearing term infants born between 2009 and 2016 were entered into the EOS calculator to obtain management recommendations. RESULTS Three hundred and sixty-two infants met the study criteria. Management according to the EOS calculator would reduce antibiotic use from 99% to 2.5% (P<0.0001) of patients. Average length of therapy would also decrease from 2.08 to 0.05 days (P<0.0001). One infant, who remained asymptomatic, had Enterococcus bacteremia and received a 7-day course of broad-spectrum antibiotics. CONCLUSIONS Culture-positive sepsis in asymptomatic neonates born to mothers with chorioamnionitis is rare. Management according to the EOS calculator would markedly reduce the potential complications of antibiotic use. These data should initiate re-examination of existing protocols for management of this cohort of patients.
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Whittaker J, Meecham L, Summerour V, Khalil S, Layton G, Yousif M, Jennings A, Wall M, Newman J. Outcome after Turndown for Elective Abdominal Aortic Aneurysm Surgery. J Vasc Surg 2017. [DOI: 10.1016/j.jvs.2017.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rider T, George S, Tidbury H, Grace R, Newman J, Al Shiekh Ali Z, Felton J. Image Gallery: A case of blastic plasmacytoid dendritic cell neoplasm. Br J Dermatol 2017; 177:e165. [PMID: 29052874 DOI: 10.1111/bjd.15816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Jimenez-Moreno A, Nikolenko N, Moat D, Mayhew A, Massey C, Gorman G, Newman J, Kierkegaard M, Atalaia A, Turner C, Lochmüller H. Getting ready for clinical trials in myotonic dystrophy type 1 with the validation of functional outcome measures. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Milligan D, Newman J, Caley M, Wainwright L, Jenkins G, Philpott M, Bishop C. 682 Development of a 3D living skin equivalent to explore the influence of senescence on the skin ageing phenotype. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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