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Goel S, Mihandoust S, Joseph A, Markowitz J, Gonzales A, Browning M. Design of Pediatric Outpatient Procedure Environments: A Pilot Study to Understand the Perceptions of Patients and Their Parents. HERD 2024; 17:183-199. [PMID: 38166516 DOI: 10.1177/19375867231220398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
OBJECTIVE To understand parent and child perception of spaces experienced during outpatient procedures and to measure their anxiety in these spaces. BACKGROUND Same-day procedures are becoming prevalent among children in the United States. While studies conducted in different types of healthcare settings show that the physical environment influences healthcare experiences of patients, there is a lack of research on patient and family perceptions of the physical environment of the outpatient centers where such procedures are conducted. METHODS This study used ecological momentary assessment to collect patient experience and anxiety data at different points during the patient's journey through an ambulatory surgical center where pediatric gastrointestinal (GI) procedures were performed. Objective and subjective measures of anxiety were collected. A Qualtrics survey asked participants' perceptions about four spaces-waiting, preprocedure, procedure, and recovery. RESULTS Child participants reported liking murals, double chairs, patient beds, wall color, and access to a television. They disliked medical equipment and lack of child-friendly furniture. Most parents liked the murals, access to a television, and nature photos, while disliking the lack of privacy, lack of toys in waiting areas, and lack of child-friendly furniture. On average, both children and parents experienced the highest anxiety levels before and during the procedure and the lowest during recovery. Between the four spaces, no significant differences were observed in the heart rate variability and skin conductance responses for both groups. CONCLUSIONS Despite the outpatient nature of the procedures, participants experienced anxiety before the GI procedure. Comfortable design features that provide distractions are preferred by children and their parents.
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Affiliation(s)
- Swati Goel
- Center for Health Facilities Design and Testing, School of Architecture, Clemson University, SC, USA
| | - Sahar Mihandoust
- Center for Health Facilities Design and Testing, School of Architecture, Clemson University, SC, USA
| | - Anjali Joseph
- Center for Health Facilities Design and Testing, School of Architecture, Clemson University, SC, USA
| | - Jonathan Markowitz
- Prisma Health, School of Medicine, University of South Carolina, Greenville, SC, USA
| | - Alec Gonzales
- Department of Industrial Engineering, Clemson University, SC, USA
| | - Matthew Browning
- Department of Parks, Recreation and Tourism Management, College of Behavioral, Social and Health Sciences, Clemson University, SC, USA
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Rosenberg A, Dominy C, Bueno BT, Pasik S, Yeshoua B, Cho B, Arvind V, Valliani AA, Markowitz J, Kim JS, Cho SK. Weekend Admission Increases Risk of Readmissions Following Elective Thoracolumbar Spinal Fusion. Global Spine J 2024; 14:667-675. [PMID: 35969028 PMCID: PMC10802542 DOI: 10.1177/21925682221120788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
STUDY DESIGN Retrospective database study. OBJECTIVES The goal of this study was to assess the influence of weekend admission on patients undergoing elective thoracolumbar spinal fusion by investigating hospital readmission outcomes and analyzing differences in demographics, comorbidities, and postoperative factors. METHODS The 2016-2018 Nationwide Readmission Database was used to identify adult patients who underwent elective thoracolumbar spinal fusion. The sample was divided into weekday and weekend admission patients. Demographics, comorbidities, complications, and discharge status data were compiled. The primary outcomes were 30-day and 90-day readmission. Univariate logistic regression analyzed the relationship between weekday or weekend admission and 30- or 90-day readmission, and multivariate regression determined the impact of covariates. RESULTS 177,847 patients were identified in total, with 176,842 in the weekday cohort and 1005 in the weekend cohort. Multivariate regression analysis found that 30-day readmissions were significantly greater for the weekend cohort after adjusting for sex, age, Medicare or Medicaid status, and comorbidity status (OR 2.00, 95% CI: 1.60-2.48; P < .001), and 90-day readmissions were also greater for the weekend cohort after adjustment (OR 2.01, 95% CI: 1.68-2.40, P < .001). CONCLUSIONS Patients undergoing elective thoracolumbar spinal fusion surgery who are initially admitted on weekends are more likely to experience hospital readmission. These patients have increased incidence of deep vein thrombosis, postoperative infection, and non-routine discharge status. These factors are potential areas of focus for reducing the impact of the "weekend effect" and improving outcomes for elective thoracolumbar spinal fusion.
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Affiliation(s)
- Ashley Rosenberg
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Calista Dominy
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brian T. Bueno
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sara Pasik
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brandon Yeshoua
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brian Cho
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Varun Arvind
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Aly A. Valliani
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jonathan Markowitz
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jun S. Kim
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Samuel K. Cho
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Tang J, Gal JS, Geng E, Duey A, Ferriter P, Sicard R, Zaidat B, Girdler S, Rhee H, Zapolsky I, Al-Attar P, Markowitz J, Kim J, Cho S. An 11-Year-Long Analysis of the Risks Associated With Age in Patients Undergoing Anterior Cervical Discectomy and Fusion in a Large, Urban Academic Hospital. Global Spine J 2023:21925682231202579. [PMID: 37703497 DOI: 10.1177/21925682231202579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/15/2023] Open
Abstract
STUDY DESIGN A retrospective database study of patients at an urban academic medical center undergoing an Anterior Cervical Discectomy and Fusion (ACDF) surgery between 2008 and 2019. OBJECTIVE ACDF is one of the most common spinal procedures. Old age has been found to be a common risk factor for postoperative complications across a plethora of spine procedures. Little is known about how this risk changes among elderly cohorts such as the difference between elderly (60+) and octogenarian (80+) patients. This study seeks to analyze the disparate rates of complications following elective ACDF between patients aged 60-69 or 70-79 and 80+ at an urban academic medical center. METHODS We identified patients who had undergone ACDF procedures using CPT codes 22,551, 22,552, and 22,554. Emergent procedures were excluded, and patients were subdivided on the basis of age. Then each cohort was propensity matched for univariate and univariate logistic regression analysis. RESULTS The propensity matching resulted in 25 pairs in both the 70-79 and 80+ y.o. cohort comparison and 60-69 and 80+ y.o. cohort comparison. None of the cohorts differed significantly in demographic variables. Differences between elderly cohorts were less pronounced: the 80+ y.o. cohort experienced only significantly higher total direct cost (P = .03) compared to the 70-79 y.o. cohort and significantly longer operative time (P = .04) compared to the 60-69 y.o. cohort. CONCLUSIONS Octogenarian patients do not face much riskier outcomes following elective ACDF procedures than do younger elderly patients. Age alone should not be used to screen patients for ACDF.
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Affiliation(s)
- Justin Tang
- Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jonathan S Gal
- Department of Anesthesiology, Perioperative, and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Eric Geng
- Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Akiro Duey
- Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Pierce Ferriter
- Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ryan Sicard
- Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bashar Zaidat
- Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Steven Girdler
- Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hannah Rhee
- Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ivan Zapolsky
- Department of Orthopedic Surgery, Penn Medicine at the University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Paul Al-Attar
- Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jonathan Markowitz
- Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jun Kim
- Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Samuel Cho
- Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Ren R, Dominy C, Bueno B, Pasik S, Markowitz J, Yeshoua B, Cho B, Arvind V, Valliani AA, Kim J, Cho S. Weekend Admission Increases Risk of Readmissions Following Elective Cervical Spinal Fusion. Neurospine 2023; 20:290-300. [PMID: 37016876 PMCID: PMC10080455 DOI: 10.14245/ns.2244816.408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 01/10/2023] [Indexed: 04/03/2023] Open
Abstract
Objective: The “weekend effect” occurs when patients cared for during weekends versus weekdays experience worse outcomes. But reasons for this effect are unclear, especially amongst patients undergoing elective cervical spinal fusion (ECSF). Our aim was to analyze whether index weekend admission affects 30- and 90-day readmission rates post-ECSF.Methods: All ECSF patients > 18 years were retrospectively identified from the 2016–2018 Healthcare Cost and Utilization Project Nationwide Readmissions Database (NRD), using unique patient linkage codes and International Classification of Diseases, Tenth Revision codes. Patient demographics, comorbidities, and outcomes were analyzed. Univariate logistic regression analyzed primary outcomes of 30- and 90-day readmission rates in weekday or weekend groups. Multivariate regression determined the impact of complications on readmission rates.Results: Compared to the weekday group (n = 125,590), the weekend group (n = 1,026) held a higher percentage of Medicare/Medicaid insurance, incurred higher costs, had longer length of stay, and fewer routine home discharge (all p < 0.001). There was no difference in comorbidity burden between weekend versus weekday admissions, as measured by the Elixhauser Comorbidity Index (p = 0.527). Weekend admissions had higher 30-day (4.30% vs. 7.60%, p < 0.001) and 90-day (7.80% vs. 16.10%, p < 0.001) readmission rates, even after adjusting for sex, age, insurance status, and comorbidities. All-cause complication rates were higher for weekend admissions (8.62% vs. 12.7%, p < 0.001), specifically deep vein thrombosis, infection, neurological conditions, and pulmonary embolism.Conclusion: Index weekend admission increases 30- and 90-day readmission rates after ECSF. In patients undergoing ECSF on weekends, postoperative care for patients at risk for specific complications will allow for improved outcomes and health care utilization.
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Affiliation(s)
- Renee Ren
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Calista Dominy
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brian Bueno
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sara Pasik
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jonathan Markowitz
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brandon Yeshoua
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brian Cho
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Varun Arvind
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Aly A. Valliani
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jun Kim
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Samuel Cho
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Corresponding Author Samuel Cho Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
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Geng EA, Gal JS, Kim JS, Martini ML, Markowitz J, Neifert SN, Tang JE, Shah KC, White CA, Dominy CL, Valliani AA, Duey AH, Li G, Zaidat B, Bueno B, Caridi JM, Cho SK. Robust prediction of nonhome discharge following elective anterior cervical discectomy and fusion using explainable machine learning. Eur Spine J 2023:10.1007/s00586-023-07621-8. [PMID: 36854862 DOI: 10.1007/s00586-023-07621-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 01/25/2023] [Accepted: 02/19/2023] [Indexed: 03/02/2023]
Abstract
PURPOSE Predict nonhome discharge (NHD) following elective anterior cervical discectomy and fusion (ACDF) using an explainable machine learning model. METHODS 2227 patients undergoing elective ACDF from 2008 to 2019 were identified from a single institutional database. A machine learning model was trained on preoperative variables, including demographics, comorbidity indices, and levels fused. The validation technique was repeated stratified K-Fold cross validation with the area under the receiver operating curve (AUROC) statistic as the performance metric. Shapley Additive Explanation (SHAP) values were calculated to provide further explainability regarding the model's decision making. RESULTS The preoperative model performed with an AUROC of 0.83 ± 0.05. SHAP scores revealed the most pertinent risk factors to be age, medicare insurance, and American Society of Anesthesiology (ASA) score. Interaction analysis demonstrated that female patients over 65 with greater fusion levels were more likely to undergo NHD. Likewise, ASA demonstrated positive interaction effects with female sex, levels fused and BMI. CONCLUSION We validated an explainable machine learning model for the prediction of NHD using common preoperative variables. Adding transparency is a key step towards clinical application because it demonstrates that our model's "thinking" aligns with clinical reasoning. Interactive analysis demonstrated that those of age over 65, female sex, higher ASA score, and greater fusion levels were more predisposed to NHD. Age and ASA score were similar in their predictive ability. Machine learning may be used to predict NHD, and can assist surgeons with patient counseling or early discharge planning.
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Affiliation(s)
- Eric A Geng
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - Jonathan S Gal
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, United States of America.,Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - Jun S Kim
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, United States of America.
| | - Michael L Martini
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - Jonathan Markowitz
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - Sean N Neifert
- Department of Neurosurgery, New York University Grossman School of Medicine, New York, United States of America
| | - Justin E Tang
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - Kush C Shah
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - Christopher A White
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - Calista L Dominy
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - Aly A Valliani
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - Akiro H Duey
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - Gavin Li
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - Bashar Zaidat
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - Brian Bueno
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - John M Caridi
- Department of Neurosurgery, McGovern Medical School at University of Texas Health, Houston, United States of America
| | - Samuel K Cho
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, United States of America
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Treuheim TDPV, Eaker L, Markowitz J, Shankar D, Meyers J, Lonner B. Anterior Vertebral Body Tethering for Scoliosis Patients With and Without Skeletal Growth Remaining: A Retrospective Review With Minimum 2-Year Follow-Up. Int J Spine Surg 2023; 17:6-16. [PMID: 36113952 PMCID: PMC10025839 DOI: 10.14444/8357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Anterior vertebral body tethering (AVBT) has been approved for skeletally immature (IM) adolescent idiopathic scoliosis patients, but the role of AVBT in patients with minimal remaining skeletal growth is controversial. The purpose of this study was to compare minimum 2-year (YR2) outcomes in skeletally IM patients vs those with minimal remaining skeletal growth. METHODS Patients with single thoracic AVBT were grouped by their preoperative (PR) skeletal maturity: IM (n = 16, Risser 0-2) vs mature (M, n = 19, Risser 3-5). Outcomes were assessed at PR, first erect (FE), and YR2. Median (range) was compared with nonparametric tests (P < 0.05). RESULTS The PR age was 12.5 (9-16) vs 15 (12-18) years with major Cobb 51° (36°-69°) and 49° (40°-69°) for IM and M, respectively. At FE, there was no difference in correction; however, at YR2, the IM group yielded a lower residual curve (15° [-16° to 38°] vs 29° [12°-42°], P = 0.008). Thoracolumbar/lumbar curves were corrected without group differences. Clinically successful correction (<35°) (15 [94%] vs 15 [79%]) and suspected cord breakages (2 [13%] vs 2 [12%]) were similar at YR2. Two overcorrections occurred, both in IM patients. Scoliosis Research Society-22 outcomes at final follow-up were similar between groups. No revision reoperations or conversions to spinal fusion were needed. CONCLUSIONS Skeletally IM patients benefit from greater growth-modulated curve correction than M patients, however, at the increased risk of overcorrection. M patients maintained clinically significant correction at latest follow-up. Longer-term follow-up is required to determine durability of outcomes for patients undergoing AVBT who have minimal remaining growth at the time of index surgery. CLINICAL RELEVANCE This study is relevant to spine surgeons, spine physiotherapists, and patients with idiopathic scoliosis. It offers evidence of clinical correction of scoliosis in mature patients. LEVEL OF EVIDENCE: 3
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Affiliation(s)
| | - Lily Eaker
- Department of Orthopaedic Surgery, Mount Sinai Hospital, New York, NY, USA
| | - Jonathan Markowitz
- Department of Orthopaedic Surgery, Mount Sinai Hospital, New York, NY, USA
| | - Dhruv Shankar
- Department of Orthopaedic Surgery, Mount Sinai Hospital, New York, NY, USA
| | - James Meyers
- Department of Orthopaedic Surgery, Mount Sinai Hospital, New York, NY, USA
| | - Baron Lonner
- Department of Orthopaedic Surgery, Mount Sinai Hospital, New York, NY, USA
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Mikhail CM, Markowitz J, Di Lenarda L, Guzman J, Vulcano E. Clinical and Radiographic Outcomes of Percutaneous Chevron-Akin Osteotomies for the Correction of Hallux Valgus Deformity. Foot Ankle Int 2022; 43:32-41. [PMID: 34293943 DOI: 10.1177/10711007211031218] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Hallux valgus is a common cause of pain and dysfunction of the foot, sometimes requiring surgical correction when conservative measures fail. Although there are many methods of correction, one of the newer techniques is minimally invasive chevron-Akin (MICA). The aim of the current study is to evaluate clinical and radiographic effectiveness of MICA and narcotic use in a large patient cohort. METHODS All patients in this retrospective study were treated by a single fellowship-trained foot and ankle orthopaedic surgeon. Patient demographics were collected for all cases. Preoperative and postoperative intermetatarsal angle (IMA) and hallux valgus angle (HVA) were measured in all patients on weightbearing 3-views radiographs. The Foot Function Index (FFI) was obtained pre- and postoperatively at each visit. All patients were prescribed regular use of ibuprofen for 3 days with acetaminophen and oxycodone reserved for breakthrough pain. Use of narcotic pain medication was recorded. RESULTS A total of 274 feet in 248 patients were included in the study. Overall, 87.9% were female and 12.1% were male. The mean preoperative IMA and HVA were 13.4 and 29.1 degrees, respectively. The postoperative IMA and HVA were 4.9 and 8.9 degrees, respectively. The mean FFI score part A was 92 preoperatively and 43 postoperatively. Patient satisfaction was 91.6%. The mean postoperative 5 mg oxycodone pill consumption was 2.2. CONCLUSION MICA is good method to correct hallux valgus deformity with low postoperative narcotic use. LEVEL OF EVIDENCE Level III, restrospective cohort study of a single surgeon practice.
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Affiliation(s)
- Christopher M Mikhail
- Department of Orthopedics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jonathan Markowitz
- Department of Orthopedics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Luca Di Lenarda
- Department of Orthopedics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Javier Guzman
- Department of Orthopedics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ettore Vulcano
- Department of Orthopedics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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8
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Cong T, Sivaganesan A, Mikhail CM, Vaishnav AS, Dowdell J, Barbera J, Kumagai H, Markowitz J, Sheha E, Qureshi SA. Facet Violation With Percutaneous Pedicle Screw Placement: Impact of 3D Navigation and Facet Orientation. HSS J 2021; 17:281-288. [PMID: 34539268 PMCID: PMC8436351 DOI: 10.1177/15563316211026324] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: The gold standard for percutaneous pedicle screw placement is 2-dimensional (2D) fluoroscopy. Data are sparse on the accuracy of 3-dimensional (3D) navigation percutaneous screw placement in minimally invasive spine procedures. Objective: We sought to compare a single surgeon's percutaneous pedicle screw placement accuracy using 2D fluoroscopy versus 3D navigation, as well as to investigate the effect of facet orientation on facet violation when using 2D fluoroscopy. Methods: We conducted a retrospective radiographic study of consecutive cohort of patients who underwent percutaneous lumbar instrumentation using either 2D fluoroscopy or 3D navigation. All procedures were performed by a single surgeon at 2 academic institutions between 2011 and 2018. Radiographic measurement of screw accuracy was assessed using a postoperative computed tomographic scan. The primary outcome was facet violation, and secondary outcomes were endplate/tip breaches, the Gertzbein-Robbins classification for cortical breaches, and the Simplified Screw Accuracy grade. Statistical comparisons were made between screws placed using 2D fluoroscopy versus 3D navigation. Axial facet angles were also measured to correlate with facet violation rates. Results: In the 138 patients included, 376 screws were placed with fluoroscopy and 193 with navigation. Superior (unfused) level facet violation was higher with 2D fluoroscopy than with 3D navigation (9% vs 0.5%), which comprises the main cause for poor screw placement. Axial facet angles exceeding 45° at L4 and 60° at L5 were correlated with facet violations. Conclusion: This retrospective study found that 3D navigation is associated with lower facet violation rates in percutaneous lumbar pedicle screw placement when compared with 2D fluoroscopy. These findings suggest that 3D navigation may be of particular value when facet joints are coronally oriented.
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Affiliation(s)
- Ting Cong
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | | | | | - Joseph Barbera
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - Evan Sheha
- Hospital for Special Surgery, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | - Sheeraz A. Qureshi
- Hospital for Special Surgery, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
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9
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Sandhu G, Velangi P, Kharoud H, Freese R, Markowitz J, Kazmirczak F, Nijjar P. Evaluation Of Prosthetic Valve Dysfunction With CT. J Cardiovasc Comput Tomogr 2021. [DOI: 10.1016/j.jcct.2021.06.289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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10
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Taree A, Mikhail CM, Markowitz J, Ranson WA, Choi B, Schwartz JT, Cho SK. Risk Factors for 30- and 90-Day Readmissions Due To Surgical Site Infection Following Posterior Lumbar Fusion. Clin Spine Surg 2021; 34:E216-E222. [PMID: 33122569 DOI: 10.1097/bsd.0000000000001095] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 07/24/2020] [Indexed: 12/13/2022]
Abstract
STUDY DESIGN This was a retrospective cohort study. OBJECTIVE Identify the independent risk factors for 30- and 90-day readmission because of surgical site infection (SSI) in patients undergoing elective posterior lumbar fusion (PLF). SUMMARY OF BACKGROUND DATA SSI is a significant cause of morbidity in the 30- and 90-day windows after hospital discharge. There remains a gap in the literature on independent risk factors for readmission because of SSI after PLF procedures. In addition, readmission for SSI after spine surgery beyond the 30-day postoperative period has not been well studied. METHODS A retrospective analysis was performed on data from the 2012 to 2014 Healthcare Cost and Utilization Project Nationwide Readmissions Database. The authors identified 65,121 patients who underwent PLF. There were 191 patients (0.30%) readmitted with a diagnosis of SSI in the 30-day readmission window, and 283 (0.43%) patients readmitted with a diagnosis of SSI in the 90-day window. Baseline patient demographics and medical comorbidities were assessed. Bivariate and multivariate analyses were performed to examine the independent risk factors for readmission because of SSI. RESULTS In the 30-day window after discharge, this study identified patients with liver disease, uncomplicated diabetes, deficiency anemia, depression, psychosis, renal failure, obesity, and Medicaid or Medicare insurance as higher risk patients for unplanned readmission with a diagnosis of SSI. The study identified the same risk factors in the 90-day window with the addition of diabetes with chronic complications, chronic pulmonary disease, and pulmonary circulation disease. CONCLUSIONS Independent risk factors for readmission because of SSI included liver disease, uncomplicated diabetes, obesity, and Medicaid insurance status. These findings suggest that additional intervention in the perioperative workup for patients with these risk factors may be necessary to lower unplanned readmission because of SSI after PLF surgery.
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Affiliation(s)
- Amir Taree
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
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11
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Moore H, Wechsler J, Frost C, Whiteside E, Baldassano R, Markowitz J, Muir AB. Comorbid Diagnosis of Eosinophilic Esophagitis and Inflammatory Bowel Disease in the Pediatric Population. J Pediatr Gastroenterol Nutr 2021; 72:398-403. [PMID: 33230079 PMCID: PMC9272133 DOI: 10.1097/mpg.0000000000003002] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIMS The incidence and prevalence of eosinophilic esophagitis (EoE) and inflammatory bowel disease (IBD) are rising with similar patterns. Co-occurrence of both diseases in the same patient has been increasingly reported. We sought to examine the pediatric population with both EoE and IBD to better understand the epidemiology and clinical implications of this overlap. METHODS We conducted a retrospective case-control study at 2 tertiary care children's hospitals. Subjects with both EoE and IBD were identified and compared with randomly selected controls with EoE and IBD alone in terms of: demographics, atopic conditions, IBD classification, location and phenotype of Crohn disease (CD), IBD medications, endoscopic findings, and histopathology. Descriptive statistics summarized the data. RESULTS Sixty-seven subjects with dual-diagnosis were identified across both institutions. The prevalence of IBD in the EoE population was 2.2% and EoE in IBD was 1.5%. Subjects with both diseases were more likely to have IgE-mediated food allergy compared with IBD alone (36% vs 7%, P < 0.001). Subjects with CD-EoE were less likely to have perianal disease than CD alone (2% vs 20%, P = 0.004). There was no difference in fibrostenotic EoE between the dual-diagnosis group and EoE alone. Treatment with a TNF-alpha inhibitor (anti-TNF) for management of preexisting IBD was protective against development of EoE with a relative risk of 0.314 [95% confidence interval [CI] 0.159-0.619]. CONCLUSIONS This is a unique population in whom the underlying pathway leading to dual-diagnosis is unclear. Concomitant atopic conditions, especially IgE-mediated food allergy, and medication exposures, particularly anti-TNFs, may help predict likelihood of developing dual-diagnosis.
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Affiliation(s)
- Hillary Moore
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Joshua Wechsler
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL 60611, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Carrie Frost
- Division of Pediatric Research, Greenville Hospital System Children’s Hospital, Greenville, SC 29605, USA
| | - Elizabeth Whiteside
- Department of Pediatrics, University of South Carolina School of Medicine-Greenville, Greenville, SC 29605, USA
| | - Robert Baldassano
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Jonathan Markowitz
- Department of Pediatrics, University of South Carolina School of Medicine-Greenville, Greenville, SC 29605, USA
- Division of Gastroenterology and Nutrition, Greenville Hospital System Children’s Hospital, Greenville, SC 29605, USA
| | - Amanda B. Muir
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
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12
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Haymaker C, Andtbacka R, Johnson D, Shaheen M, Rahimian S, Chunduru S, Gabrail N, Doolittle G, Puzanov I, Markowitz J, Bernatchez C, Diab A. 1083MO Final results from ILLUMINATE-204, a phase I/II trial of intratumoral tilsotolimod in combination with ipilimumab in PD-1 inhibitor refractory advanced melanoma. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1207] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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13
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Velangi P, Maharaj V, Athwal S, Bartos J, Markowitz J, Duval S, Nijjar P. CT Coronary Plaque Characteristics Predict Ischemia Detected By Invasive Fractional Flow Reserve. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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14
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Velangi P, Kalra R, Markowitz J, Nijjar P. Utility Of CT In Diagnosis Of Prosthetic Valve Endocarditis. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Lam A, Richardson SS, Buksbaum J, Markowitz J, Henry MW, Miller AO, Rozbruch SR, Fragomen AT. Chronic Osteomyelitis of the tibia and ankle treated with Limb Salvage Reconstruction. J Bone Jt Infect 2019; 4:306-313. [PMID: 31966963 PMCID: PMC6960027 DOI: 10.7150/jbji.40337] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 11/03/2019] [Indexed: 11/23/2022] Open
Abstract
Introduction: To confirm the success of our limb salvage treatment protocol and determine what factors are predictive of success versus failure in limb salvage techniques for patients with chronic osteomyelitis of the tibia and ankle. Methods: Retrospective case series analyzing factors and outcomes in patients who underwent limb salvage techniques for chronic osteomyelitis of tibia or ankle. Main outcome measurements included infection controlled without the need for amputation or chronic antibiotic suppression and union of infected non-unions. Results: Mean follow-up was 3.9 years. Out of the sixty-seven patients (mean age: 51.4 years) treated for chronic osteomyelitis, fifty-four had an associated non-union. Sixty-one patients (91.0%) had their infection controlled by limb salvage. Five ultimately required amputation and one remained on daily chronic antibiotics. Diabetics complicated with neuropathy and increasing numbers of limb salvage surgeries were associated with a significantly higher failure rate. Forty-eight out of fifty-four patients (88.9%) also had successful healing of their infected non-union. Diabetes and need for more limb salvage surgeries were also found to have a significantly higher failure rate. Conclusions: Limb salvage is a reliable and successful treatment for patients with chronic osteomyelitis and infected non-unions of the lower extremities. Diabetic neuropathy is a risk factor that impedes success. Level of Evidence: Prognostic Level IV.
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Affiliation(s)
- Aaron Lam
- Maimonides Medical Center, 4802 10th Ave, Brooklyn, NY 11219, USA
| | - Shawn S Richardson
- Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery, Weill Cornell Medical College, 535 East 70th Street, New York, NY 10021, USA
| | - Josh Buksbaum
- Emory University, 201 Dowman Dr, Atlanta, GA 30322, USA
| | | | - Michael W Henry
- Infectious Disease Service, Hospital for Special Surgery, Weill Cornell Medical College, 535 East 70th Street, New York, NY 10021, USA
| | - Andy O Miller
- Infectious Disease Service, Hospital for Special Surgery, Weill Cornell Medical College, 535 East 70th Street, New York, NY 10021, USA
| | - S Robert Rozbruch
- Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery, Weill Cornell Medical College, 535 East 70th Street, New York, NY 10021, USA
| | - Austin T Fragomen
- Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery, Weill Cornell Medical College, 535 East 70th Street, New York, NY 10021, USA
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16
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Kim S, Khushalani N, Eroglu Z, Russell J, Wuthrick E, Caudell J, Harrison L, Aoki M, Shah H, Blakaj D, Markowitz J, Chen DT, Messina J, Rose T, Tsai K, Brohl A. A phase II, randomized study of nivolumab (NIVO) and Ipilimumab (IPI) versus NIVO, IPI and stereotactic body radiation therapy (SBRT) for metastatic Merkel cell carcinoma (MCC, NCT03071406): A preliminary report. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz255.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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17
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Diab A, Haymaker C, Bernatchez C, Andtbacka R, Shaheen M, Johnson D, Markowitz J, Puzanov I, Murthy R, Johnson D, James M, Chunduru S, Geib J, Swann S, Rahimian S, Hwu P. Intratumoral (IT) Injection of the TLR9 agonist tilsotolimod (IMO-2125) in combination with ipilimumab (ipi) triggers durable responses in PD-1 inhibitor refractory metastatic melanoma (rMM): Results from a multicenter, phase I/II study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy289.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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18
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Eke R, Li T, White A, Tariq T, Markowitz J, Lenov A. Systematic review of histological remission criteria in eosinophilic esophagitis. JGH Open 2018; 2:158-165. [PMID: 30483582 PMCID: PMC6207047 DOI: 10.1002/jgh3.12059] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 05/03/2018] [Accepted: 05/07/2018] [Indexed: 12/15/2022]
Abstract
Elemental diets, dietary elimination, and steroid therapies are the most common therapies in the clinical trials for eosinophilic esophagitis (EoE). Histological findings (usually reported as eosinophils per microscopic high‐powered field [hpf]) remain the most common end‐point used to define response. Yet, the threshold for defining “response” and “remission” are ill‐defined among consensus guidelines and may vary from study to study. We conducted a systematic literature review of articles on eosinophilic esophagitis, published between January 2007 and November 2017, considering histological remission as the primary outcome. We abstracted treatment information and definitions of histological remission or response. A comparison of definitions of histological remission across and within institutions was performed. A total of 61 articles were included in this review, with approximately 60% of the studies published from centers in the United States. Histological definitions of remission of EoE ranged from 0 to ≤20 eosinophils/hpf. The most stringent criteria, ranging from 0 to ≤5 eosinophils/hpf, were commonly used in interventional trial studies that examined the effects of new treatments. We found remarkable variability in definitions between studies, treatment types, and regions. Age or epidemiological distribution of study subjects did not influence the criteria for histological remission. Clinical and histological improvements are important measures of the effects of treatment. Histological findings, the most objective measure of treatment, should provide an optimal method for comparing the effectiveness of various treatments. Yet, our findings suggest a lack of consistent remission criteria in published studies. Considering these inconsistencies, it is difficult to compare the effectiveness of various treatments.
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Affiliation(s)
- Ransome Eke
- Division of Epidemiology and Biostatistics Western Michigan University M.D. Homer Stryker School of Medicine Kalamazoo Michigan US
| | - Tong Li
- Division of Epidemiology and Biostatistics Western Michigan University M.D. Homer Stryker School of Medicine Kalamazoo Michigan US
| | - Anna White
- Medical Library Western Michigan University M.D. Homer Stryker School of Medicine Kalamazoo Michigan US
| | - Tooba Tariq
- Department of Internal Medicine Western Michigan University M.D. Homer Stryker School of Medicine Kalamazoo Michigan US
| | - Jonathan Markowitz
- Division of Pediatric Gastroenterology Greenville Children's Hospital Greenville South Carolina US
| | - Andrey Lenov
- Allergy-Asthma-Immunology Clinic, Department of Pediatric and Adolescent Medicine Western Michigan University M.D. Homer Stryker School of Medicine Kalamazoo Michigan US
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19
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Helsel BC, Williams JE, Lawson K, Liang J, Markowitz J. Telemedicine and Mobile Health Technology Are Effective in the Management of Digestive Diseases: A Systematic Review. Dig Dis Sci 2018; 63:1392-1408. [PMID: 29663265 DOI: 10.1007/s10620-018-5054-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 03/31/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Mobile applications and interactive websites are an increasingly used method of telemedicine, but their use lacks evidence in digestive diseases. AIM This study aims to explore digestive disease studies that use telemedicine to effectively manage disease activity, help monitor symptoms, improve compliance to the treatment protocol, increase patient satisfaction, and enhance the patient-to-provider communication. METHODS EBSCO, PubMed, and Web of Science databases were searched using Medical Subject Headings and other keywords to identify studies that utilized telemedicine in patients with digestive disease. The PRISMA guidelines were used to identify 20 research articles that had data aligning with 4 common overlapping themes including, patient compliance (n = 13), patient satisfaction (n = 11), disease activity (n = 15), and quality of life (n = 13). The studies focused on digestive diseases including inflammatory bowel disease (n = 7), ulcerative colitis (n = 4), Crohn's Disease (n = 1), irritable bowel syndrome (n = 6), and colorectal cancer (n = 2). RESULTS From the studies included in this systematic review, patient compliance and patient satisfaction ranged between 25.7-100% and 74-100%, respectively. Disease activity, measured by symptom severity scales and physiological biomarkers, showed improvements following telemedicine interventions in several, but not all, studies. Similar to disease activity, general and disease-specific quality of life showed improvements following telemedicine interventions in as little as 12 weeks in some studies. CONCLUSION Telemedicine and mobile health technology may be effective in managing disease activity and improving quality of life in digestive diseases. Future studies should explore both gastrointestinal and gastroesophageal diseases using these types of interventions.
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Affiliation(s)
- Brian C Helsel
- Department of Public Health Sciences, Clemson University, P.O. Box 340745, Clemson, SC, 29634-0745, USA.
| | - Joel E Williams
- Department of Public Health Sciences, Clemson University, P.O. Box 340745, Clemson, SC, 29634-0745, USA
| | - Kristen Lawson
- Department of Nursing, Clemson University, Clemson, SC, USA
| | - Jessica Liang
- Department of Healthcare Leadership and Management, Medical University of South Carolina, Charleston, SC, USA
| | - Jonathan Markowitz
- Department of Pediatric Gastroenterology, Greenville Health System, Greenville, SC, USA
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20
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Patel S, Hodi F, Gabrilovich D, Chin M, Gibney G, Goldsberry A, Gonzalez R, Hurt J, Markowitz J, Whitman E, Meyer C, Salama A. A phase 1b/2 study of omaveloxolone in combination with checkpoint inhibitors in patients with unresectable or metastatic melanoma. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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21
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Narain AS, Hijji FY, Haws BE, Kudaravalli KT, Yom KH, Markowitz J, Singh K. Impact of body mass index on surgical outcomes, narcotics consumption, and hospital costs following anterior cervical discectomy and fusion. J Neurosurg Spine 2017; 28:160-166. [PMID: 29192877 DOI: 10.3171/2017.6.spine17288] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Given the increasing prevalence of obesity, more patients with a high body mass index (BMI) will require surgical treatment for degenerative spinal disease. In previous investigations of lumbar spine pathology, obesity has been associated with worsened postoperative outcomes and increased costs. However, few studies have examined the association between BMI and postoperative outcomes following anterior cervical discectomy and fusion (ACDF) procedures. Thus, the purpose of this study was to compare surgical outcomes, postoperative narcotics consumption, complications, and hospital costs among BMI stratifications for patients who have undergone primary 1- to 2-level ACDF procedures. METHODS The authors retrospectively reviewed a prospectively maintained surgical database of patients who had undergone primary 1- to 2-level ACDF for degenerative spinal pathology between 2008 and 2015. Patients were stratified by BMI as follows: normal weight (< 25.0 kg/m2), overweight (25.0-29.9 kg/m2), obese I (30.0-34.9 kg/m2), or obese II-III (≥ 35.0 kg/m2). Differences in patient demographics and preoperative characteristics were compared across the BMI cohorts using 1-way ANOVA or chi-square analysis. Multivariate linear or Poisson regression with robust error variance was used to determine the presence of an association between BMI category and narcotics utilization, improvement in visual analog scale (VAS) scores, incidence of complications, arthrodesis rates, reoperation rates, and hospital costs. Regression analyses were controlled for preoperative demographic and procedural characteristics. RESULTS Two hundred seventy-seven patients were included in the analysis, of whom 20.9% (n = 58) were normal weight, 37.5% (n = 104) were overweight, 24.9% (n = 69) were obese I, and 16.6% (n = 46) were obese II-III. A higher BMI was associated with an older age (p = 0.049) and increased comorbidity burden (p = 0.001). No differences in sex, smoking status, insurance type, diagnosis, presence of neuropathy, or preoperative VAS pain scores were found among the BMI cohorts (p > 0.05). No significant differences were found among these cohorts as regards operative time, intraoperative blood loss, length of hospital stay, and number of operative levels (p > 0.05). Additionally, no significant differences in postoperative narcotics consumption, VAS score improvement, complication rates, arthrodesis rates, reoperation rates, or total direct costs existed across BMI stratifications (p > 0.05). CONCLUSIONS Patients with a higher BMI demonstrated surgical outcomes, narcotics consumption, and hospital costs comparable to those of patients with a lower BMI. Thus, ACDF procedures are both safe and effective for all patients across the entire BMI spectrum. Patients should be counseled to expect similar rates of postoperative complications and eventual clinical improvement regardless of their BMI.
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22
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Louie PK, Paul JC, Markowitz J, Bell JA, Basques BA, Yacob A, An HS. Stability-preserving decompression in degenerative versus congenital spinal stenosis: demographic patterns and patient outcomes. Spine J 2017; 17:1420-1425. [PMID: 28456675 DOI: 10.1016/j.spinee.2017.04.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 03/25/2017] [Accepted: 04/24/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Although lumbar spinal stenosis often presents as a degenerative condition (degenerative stenosis [DS]), some patients present with symptoms from lifelong narrowing of the spinal canal. These patients have congenital stenosis (CS) and present with symptoms of stenosis at a younger age. Patients with CS often have a distinct pathophysiology with fewer degenerative changes but present with multilevel involvement. In the setting of neurologic symptoms, decompression alone while preserving stability has been proposed for both patient populations. PURPOSE The purpose of this study is to evaluate if the different etiology for narrowing in CS and DS results in a different natural history of pain progression, different locations requiring decompression, and different outcomes following a stability-preserving decompression procedure. STUDY DESIGN/SETTING This study used a retrospective cohort study patient sample: We retrospectively reviewed consecutive patients of a single surgeon with DS or CS who underwent surgical decompression without fusion between 2008 and 2014. Patients were excluded if they had undergone a previous lumbar surgical procedure (decompression or fusion) or follow-up less than 12 months. OUTCOME MEASURES Pre- and postoperative clinical outcome scores including visual analogue scale (VAS) and Oswestry Disability Index (ODI) were recorded. Postoperatively, data were collected regarding complications, the presence of new radicular or myelopathic symptoms, and necessity of reoperation in the lumbar spine. METHODS Demographic information included age, sex, body mass index, smoking status, and Charleston Comorbidity Index (CCI). Preoperative clinical symptoms as well as the presence of lower extremity radiculopathy and claudication were evaluated. Patients were determined to have a diagnosis of CS by the treating surgeon if primary radiographs revealed shortened pedicles and decreased cross-sectional area of the spinal canal as detailed by previous studies. Binary outcomes were compared between congenital and degenerative cohorts using bivariate and multivariate logistic regression. Multivariate regressions controlled for baseline patient and operative characteristics. RESULTS The average age of the DS cohort was 66.7±10.7 years, whereas for the CS group, it was 47.1±9.2 years. Average follow-up was 27.6 months. The patients with DS had significantly more comorbidities as shown by the CCI score (2.8±1.6 vs. 0.5±0.6); p<.001) and the American Society of Anesthesiologists (ASA) score ≥3 (52.8% vs. 11.1%; p<.001). Patients with CS presented with higher VAS back (8.0 vs. 5.1; p=.008) and leg (7.9 vs. 4.5; p<.001) scores. Patients with DS presented with significantly greater duration of preoperative back pain and leg pain (42.7 vs. 30.5 months; p=.042). Postoperatively, there were no significant differences in VAS back, leg, or ODI scores. However, a trend toward a lower VAS leg score was present in the patients with CS when compared with patients with DS (2.6±3.0 vs. 4.2±3.2; p<.117). Both patient groups experienced similar levels of symptomatic relief and improvement in VAS and ODI scores. There were no significant differences in new-onset radicular symptoms requiring conservative treatment or reoperation. In both groups combined, 81.9% of patients reported resolution of lower extremity symptoms at final follow-up. Overall, 20.6% of patients experienced new lower-extremity radicular symptoms after a period of resolution of symptoms postoperatively. There were significantly more reoperations following surgical decompression in patients with DS (13.9% vs. 2.8%; p=.02). CONCLUSIONS Patients with CS and patients with DS respond well to decompression alone, without a supplemental fusion, despite differences in pain experience and presentation. The localization of pathology requiring decompression is similar. The patients with DS were more susceptible to require another operation resulting in a fusion, which confirms the theory that initial microinstability can progress in DS, but is likely not part of the disease process in CS. At just over 2 years after decompression, patients with CS may not need to be treated by a fusion in the setting of lower back pain; however, longer-term follow up is necessary to further assess these outcomes.
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Affiliation(s)
- Philip K Louie
- Rush University Medical Center, Department of Orthopaedic Surgery, Chicago, IL.
| | - Justin C Paul
- Rush University Medical Center, Department of Orthopaedic Surgery, Chicago, IL
| | - Jonathan Markowitz
- Rush University Medical Center, Department of Orthopaedic Surgery, Chicago, IL
| | - Joshua A Bell
- Rush University Medical Center, Department of Orthopaedic Surgery, Chicago, IL
| | - Bryce A Basques
- Rush University Medical Center, Department of Orthopaedic Surgery, Chicago, IL
| | - Alem Yacob
- Rush University Medical Center, Department of Orthopaedic Surgery, Chicago, IL
| | - Howard S An
- Rush University Medical Center, Department of Orthopaedic Surgery, Chicago, IL
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23
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Muir AB, Wang ML, Metz D, Falk G, Markowitz J, Spergel JM, Liacouras CA. Proton pump inhibitor-responsive oesophageal eosinophilia: too early to change clinical practice. Gut 2017; 66:979-980. [PMID: 27464706 PMCID: PMC5568693 DOI: 10.1136/gutjnl-2016-312601] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 07/10/2016] [Indexed: 01/07/2023]
Affiliation(s)
- Amanda B Muir
- Division of Gastroenterology, Hepatology, and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA,Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mei-Lun Wang
- Division of Gastroenterology, Hepatology, and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA,Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - David Metz
- Division of Gastroenterology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Gary Falk
- Division of Gastroenterology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jonathan Markowitz
- Division of Pediatric Gastroenterology, University of South Carolina School of Medicine-Greenville, Greenville, South Carolina, USA
| | - Jonathan M Spergel
- Division of Gastroenterology, Hepatology, and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA,Division of Allergy and Immunology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Chris A Liacouras
- Division of Gastroenterology, Hepatology, and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA,Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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24
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Dellon ES, Katzka DA, Collins MH, Hamdani M, Gupta SK, Hirano I, Lewis J, Markowitz J, Nurko S, Wo J, Dellon E, Gunasekaran TS, Hirano I, Gupta S, Pasternak B, Ellis M, Peterson K, Falk G, Leung J, Prestridge L, Hart M, Leleiko N, Vaezi M, Cherry R, Katzka D, Friedenberg K, Assouline-Dayan Y, Mukkada V. Budesonide Oral Suspension Improves Symptomatic, Endoscopic, and Histologic Parameters Compared With Placebo in Patients With Eosinophilic Esophagitis. Gastroenterology 2017; 152:776-786.e5. [PMID: 27889574 DOI: 10.1053/j.gastro.2016.11.021] [Citation(s) in RCA: 145] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 11/14/2016] [Accepted: 11/16/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS Pharmacologic treatment of eosinophilic esophagitis (EoE) is limited to off-label use of corticosteroids not optimized for esophageal delivery. We performed a randomized, controlled phase 2 trial to assess the ability of budesonide oral suspension (BOS), a novel muco-adherent topical steroid formulation, to reduce symptoms and esophageal eosinophilia in adolescents and adults with EoE. METHODS In this multicenter, randomized, double-blind, placebo-controlled, parallel-group trial, 93 EoE patients between the ages of 11 and 40 years with dysphagia and active esophageal eosinophilia were randomized to receive either BOS 2 mg or placebo twice daily for 12 weeks. Co-primary outcomes were change in Dysphagia Symptom Questionnaire (DSQ) score from baseline, and proportion of patients with a histologic response (≤6 eosinophils/high-power field) after treatment. Endoscopic severity scores and safety parameters were assessed. RESULTS At baseline, mean DSQ scores were 29.3 and 29.0, and mean peak eosinophil counts were 156 and 130 per hpf in the BOS and placebo groups, respectively. After treatment, DSQ scores were 15.0 and 21.5, and mean peak eosinophil counts were 39 and 113 per high-power field, respectively (P < .05 for all). For BOS vs placebo, change in DSQ score was -14.3 vs -7.5 (P = .0096), histologic response rates were 39% vs 3% (P < .0001), and change in endoscopic severity score was -3.8 vs 0.4 (P < .0001). Adverse events were similar between groups. CONCLUSIONS Treatment with BOS was well tolerated in adolescent and young adult patients with EoE and resulted in improvement in symptomatic, endoscopic, and histologic parameters using validated outcome instruments. ClinicalTrials.gov ID NCT01642212.
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Affiliation(s)
- Evan S Dellon
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - David A Katzka
- Division of Gastroenterology, Mayo Clinic, Rochester, Minnesota
| | - Margaret H Collins
- Department of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
| | | | - Sandeep K Gupta
- Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana
| | - Ikuo Hirano
- Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
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Prins K, Weir E, Markowitz J, Pritzker M, Madlon-Kay R, Thenappan T. Pulmonary Pulse-Wave Transit Time Is a Noninvasive Marker of Intrinsic Pulmonary Vascular Disease. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.1027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Zambirinis CP, Barilla R, Ego-Osuala M, Blobstein R, Avanzi A, Markowitz J, Greco S, Deutsch M, Rao RS, Miller G. Gamma delta T cells regulate pancreatitis. J Am Coll Surg 2013. [DOI: 10.1016/j.jamcollsurg.2013.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abadie J, Abbott BP, Abbott R, Adhikari R, Ajith P, Allen B, Allen G, Amador Ceron E, Amin RS, Anderson SB, Anderson WG, Arain MA, Araya M, Aso Y, Aston S, Aufmuth P, Aulbert C, Babak S, Baker P, Ballmer S, Barker D, Barr B, Barriga P, Barsotti L, Barton MA, Bartos I, Bassiri R, Bastarrika M, Behnke B, Benacquista M, Bennett MF, Betzwieser J, Beyersdorf PT, Bilenko IA, Billingsley G, Biswas R, Black E, Blackburn JK, Blackburn L, Blair D, Bland B, Bock O, Bodiya TP, Bondarescu R, Bork R, Born M, Bose S, Brady PR, Braginsky VB, Brau JE, Breyer J, Bridges DO, Brinkmann M, Britzger M, Brooks AF, Brown DA, Bullington A, Buonanno A, Burmeister O, Byer RL, Cadonati L, Cain J, Camp JB, Cannizzo J, Cannon KC, Cao J, Capano C, Cardenas L, Caudill S, Cavaglià M, Cepeda C, Chalermsongsak T, Chalkley E, Charlton P, Chatterji S, Chelkowski S, Chen Y, Christensen N, Chua SSY, Chung CTY, Clark D, Clark J, Clayton JH, Conte R, Cook D, Corbitt TRC, Cornish N, Coward D, Coyne DC, Creighton JDE, Creighton TD, Cruise AM, Culter RM, Cumming A, Cunningham L, Dahl K, Danilishin SL, Danzmann K, Daudert B, Davies G, Daw EJ, Dayanga T, DeBra D, Degallaix J, Dergachev V, DeSalvo R, Dhurandhar S, Díaz M, Donovan F, Dooley KL, Doomes EE, Drever RWP, Driggers J, Dueck J, Duke I, Dumas JC, Dwyer S, Edgar M, Edwards M, Effler A, Ehrens P, Etzel T, Evans M, Evans T, Fairhurst S, Faltas Y, Fan Y, Fazi D, Fehrmann H, Finn LS, Flasch K, Foley S, Forrest C, Fotopoulos N, Frede M, Frei M, Frei Z, Freise A, Frey R, Fricke TT, Friedrich D, Fritschel P, Frolov VV, Fulda P, Fyffe M, Garofoli JA, Ghosh S, Giaime JA, Giampanis S, Giardina KD, Goetz E, Goggin LM, González G, Goßler S, Grant A, Gras S, Gray C, Greenhalgh RJS, Gretarsson AM, Grosso R, Grote H, Grunewald S, Gustafson EK, Gustafson R, Hage B, Hallam JM, Hammer D, Hammond GD, Hanna C, Hanson J, Harms J, Harry GM, Harry IW, Harstad ED, Haughian K, Hayama K, Hayler T, Heefner J, Heng IS, Heptonstall A, Hewitson M, Hild S, Hirose E, Hoak D, Hodge KA, Holt K, Hosken DJ, Hough J, Howell E, Hoyland D, Hughey B, Husa S, Huttner SH, Ingram DR, Isogai T, Ivanov A, Johnson WW, Jones DI, Jones G, Jones R, Ju L, Kalmus P, Kalogera V, Kandhasamy S, Kanner J, Katsavounidis E, Kawabe K, Kawamura S, Kawazoe F, Kells W, Keppel DG, Khalaidovski A, Khalili FY, Khan R, Khazanov E, Kim H, King PJ, Kissel JS, Klimenko S, Kokeyama K, Kondrashov V, Kopparapu R, Koranda S, Kozak D, Kringel V, Krishnan B, Kuehn G, Kullman J, Kumar R, Kwee P, Lam PK, Landry M, Lang M, Lantz B, Lastzka N, Lazzarini A, Leaci P, Lei M, Leindecker N, Leonor I, Lin H, Lindquist PE, Littenberg TB, Lockerbie NA, Lodhia D, Lormand M, Lu P, Lubinski M, Lucianetti A, Lück H, Lundgren A, Machenschalk B, MacInnis M, Mageswaran M, Mailand K, Mak C, Mandel I, Mandic V, Márka S, Márka Z, Markosyan A, Markowitz J, Maros E, Martin IW, Martin RM, Marx JN, Mason K, Matichard F, Matone L, Matzner RA, Mavalvala N, McCarthy R, McClelland DE, McGuire SC, McIntyre G, McKechan DJA, Mehmet M, Melatos A, Melissinos AC, Mendell G, Menéndez DF, Mercer RA, Merrill L, Meshkov S, Messenger C, Meyer MS, Miao H, Miller J, Mino Y, Mitra S, Mitrofanov VP, Mitselmakher G, Mittleman R, Miyakawa O, Moe B, Mohanty SD, Mohapatra SRP, Moreno G, Mors K, Mossavi K, MowLowry C, Mueller G, Müller-Ebhardt H, Mukherjee S, Mullavey A, Munch J, Murray PG, Nash T, Nawrodt R, Nelson J, Newton G, Nishida E, Nishizawa A, O’Dell J, O’Reilly B, O’Shaughnessy R, Ochsner E, Ogin GH, Oldenburg R, Ottaway DJ, Ottens RS, Overmier H, Owen BJ, Page A, Pan Y, Pankow C, Papa MA, Patel P, Pathak D, Pedraza M, Pekowsky L, Penn S, Peralta C, Perreca A, Pickenpack M, Pinto IM, Pitkin M, Pletsch HJ, Plissi MV, Postiglione F, Principe M, Prix R, Prokhorov L, Puncken O, Quetschke V, Raab FJ, Rabeling DS, Radkins H, Raffai P, Raics Z, Rakhmanov M, Raymond V, Reed CM, Reed T, Rehbein H, Reid S, Reitze DH, Riesen R, Riles K, Roberts P, Robertson NA, Robinson C, Robinson EL, Roddy S, Röver C, Rollins J, Romano JD, Romie JH, Rowan S, Rüdiger A, Ryan K, Sakata S, Sammut L, Sancho de la Jordana L, Sandberg V, Sannibale V, Santamaría L, Santostasi G, Saraf S, Sarin P, Sathyaprakash BS, Sato S, Satterthwaite M, Saulson PR, Savage R, Schilling R, Schnabel R, Schofield R, Schulz B, Schutz BF, Schwinberg P, Scott J, Scott SM, Searle AC, Seifert F, Sellers D, Sengupta AS, Sergeev A, Shapiro B, Shawhan P, Shoemaker DH, Sibley A, Siemens X, Sigg D, Sintes AM, Skelton G, Slagmolen BJJ, Slutsky J, Smith JR, Smith MR, Smith ND, Somiya K, Sorazu B, Speirits F, Stein AJ, Stein LC, Steplewski S, Stochino A, Stone R, Strain KA, Strigin S, Stroeer A, Stuver AL, Summerscales TZ, Sung M, Susmithan S, Sutton PJ, Szokoly GP, Talukder D, Tanner DB, Tarabrin SP, Taylor JR, Taylor R, Thorne KA, Thorne KS, Thüring A, Titsler C, Tokmakov KV, Torres C, Torrie CI, Traylor G, Trias M, Turner L, Ugolini D, Urbanek K, Vahlbruch H, Vallisneri M, Van Den Broeck C, van der Sluys MV, van Veggel AA, Vass S, Vaulin R, Vecchio A, Veitch J, Veitch PJ, Veltkamp C, Villar A, Vorvick C, Vyachanin SP, Waldman SJ, Wallace L, Wanner A, Ward RL, Wei P, Weinert M, Weinstein AJ, Weiss R, Wen L, Wen S, Wessels P, West M, Westphal T, Wette K, Whelan JT, Whitcomb SE, Whiting BF, Wilkinson C, Willems PA, Williams HR, Williams L, Willke B, Wilmut I, Winkelmann L, Winkler W, Wipf CC, Wiseman AG, Woan G, Wooley R, Worden J, Yakushin I, Yamamoto H, Yamamoto K, Yeaton-Massey D, Yoshida S, Zanolin M, Zhang L, Zhang Z, Zhao C, Zotov N, Zucker ME, Zweizig J, Buchner S. Publisher’s Note: Search for gravitational waves associated with the August 2006 timing glitch of the Vela pulsar [Phys. Rev. D83, 042001 (2011)]. Int J Clin Exp Med 2012. [DOI: 10.1103/physrevd.85.089902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Jacobs K, Foley G, Punnett L, Hall V, Gore R, Brownson E, Ansong E, Markowitz J, McKinnon M, Steinberg S, Ing A, Wuest E, Dibiccari L. University students' notebook computer use: lessons learned using e-diaries to report musculoskeletal discomfort. Ergonomics 2011; 54:206-219. [PMID: 21294018 DOI: 10.1080/00140139.2010.544764] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The objective of this pilot study was to identify if notebook accessories (ergonomic chair, desktop monitor and notebook riser) combined with a wireless keyboard, mouse and participatory ergonomics training would have the greatest impact on reducing self-reported upper extremity musculoskeletal discomfort in university students. In addition to pre-post computing and health surveys, the Ecological Momentary Assessment was used to capture change in discomfort over time using a personal digital assistant (PDA) as the e-diary. The PDA was programmed with a survey containing 45 questions. Four groups of university students were randomised to either intervention (three external computer accessories) or to control. Participants reported less discomfort with the ergonomic chair and notebook riser based on the pre-post survey data and the e-diary/PDA ANOVA analysis. However, the PDA data, adjusted for the effect of hours per day of computer use, showed no benefit of the chair and limited benefit from the riser. Statement of Relevance:University students' use of notebook computers has increased. This study found evidence of a positive effect of an adjustable chair or notebook riser when combined with ergonomic training on reducing discomfort. Daily notebook computer use of 4 h was confirmed as a risk factor. Without some form of ergonomic intervention, these students are likely to enter the workforce with poor computing habits, which places them on the road to future injuries as technology continues to play a dominant role in their lives.
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Affiliation(s)
- K Jacobs
- Boston University Sargent College, Department of Occupational Therapy, Boston, MA, USA.
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Cao Y, Grossberg S, Markowitz J. Learned reorganization of invariant object category selectivity in inferotemporal cortex during eye movement search. J Vis 2010. [DOI: 10.1167/9.8.791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Turner D, Leach ST, Mack D, Uusoue K, McLernon R, Hyams J, Leleiko N, Walters TD, Crandall W, Markowitz J, Otley AR, Griffiths AM, Day AS. Faecal calprotectin, lactoferrin, M2-pyruvate kinase and S100A12 in severe ulcerative colitis: a prospective multicentre comparison of predicting outcomes and monitoring response. Gut 2010; 59:1207-12. [PMID: 20801771 DOI: 10.1136/gut.2010.211755] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To compare four faecal markers for their ability to predict steroid refractoriness in severe paediatric ulcerative colitis (UC). Construct validity and responsiveness to change were also assessed. METHODS This was a prospective multicentre cohort study. Stool samples from 101 children (13.3 + or - 3.6 years; Pediatric UC Activity Index (PUCAI) at admission 72 + or - 12 points) were obtained at the third day of intravenous steroid therapy. Repeated samples at discharge were obtained from 24 children. Predictive validity was assessed using diagnostic utility statistics to predict steroid failure (ie, the need for salvage treatment). Concurrent validity was assessed using correlational analysis with the following constructs: PUCAI, Lindgren and Seo scores, physician's global assessment, albumin, erythrocyte sedimentation rate and C-reactive protein (CRP). Responsiveness was assessed using test utility and correlational strategies. RESULTS Median values (IQR) were very high at baseline for all four markers (calprotectin 4215 microg/g (2297-8808); lactoferrin 212 microg/g (114-328); M2-pyruvate kinase (M2-PK) 363 U/g (119-3104); and S100A12 469 microg/g (193-1112)). M2-PK was numerically superior to the other three markers and CRP in predicting response to corticosteroid treatment (area under the receiver operating characteristic (ROC) curve 0.75 (95% CI 0.64 to 0.85; p<0.001) vs <0.65 for the others). However, it did not add to the predictive ability of the PUCAI (area under the ROC 0.81 (95% CI 0.73 to 0.89)). M2-PK also had the highest construct validity but with a modest mean correlation with all constructs (r=0.3; p<0.05). None of the markers was responsive to change (Spearman's rho correlation with change in the PUCAI <0.1; p>0.05, area under the ROC curve <0.65; p>0.05). CONCLUSIONS The four markers were greatly elevated in severe paediatric UC. Only M2-PK had good construct and predictive validity, and none was responsive to change. The PUCAI, a simple clinical index, performed better than the faecal markers in predicting outcome following a course of intravenous corticosteroids in severe UC.
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Affiliation(s)
- D Turner
- Paediatric Gastroenterology and Nutrition Unit, Shaare Zedek Medical Center, The Hebrew University of Jerusalem, POB 3235, Jerusalem 91031, Israel.
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Markowitz J, Cao Y, Grossberg S. How do Task-dependent Attentional Demands Alter How Objects are Learned? J Vis 2010. [DOI: 10.1167/10.7.958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Moraes JCD, Berezin E, Markowitz J, Hong T, Seljan P. Hospitalizations due to pneumonia and case-fatality rates in Brazil between 2003 and 2007. Int J Infect Dis 2010. [DOI: 10.1016/j.ijid.2010.02.1937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Abbott BP, Abbott R, Adhikari R, Ajith P, Allen B, Allen G, Amin RS, Anderson SB, Anderson WG, Arain MA, Araya M, Armandula H, Armor P, Aso Y, Aston S, Aufmuth P, Aulbert C, Babak S, Baker P, Ballmer S, Bantilan H, Barish BC, Barker C, Barker D, Barr B, Barriga P, Barsotti L, Barton MA, Bartos I, Bassiri R, Bastarrika M, Behnke B, Benacquista M, Betzwieser J, Beyersdorf PT, Bilenko IA, Billingsley G, Biswas R, Black E, Blackburn JK, Blackburn L, Blair D, Bland B, Bodiya TP, Bogue L, Bork R, Boschi V, Bose S, Brady PR, Braginsky VB, Brau JE, Brinkmann M, Brooks AF, Brown DA, Brunet G, Bullington A, Buonanno A, Burmeister O, Byer RL, Cadonati L, Cagnoli G, Camp JB, Cannizzo J, Cannon KC, Cao J, Cardenas L, Cardoso V, Caride S, Casebolt T, Castaldi G, Caudill S, Cavaglià M, Cepeda C, Chalkley E, Charlton P, Chatterji S, Chelkowski S, Chen Y, Christensen N, Clark D, Clark J, Clayton JH, Cokelaer T, Conte R, Cook D, Corbitt TRC, Cornish N, Coyne DC, Creighton JDE, Creighton TD, Cruise AM, Cumming A, Cunningham L, Cutler RM, Danzmann K, Daudert B, Davies G, Debra D, Degallaix J, Dergachev V, Desai S, Desalvo R, Dhurandhar S, Díaz M, Dickson J, Dietz A, Donovan F, Dooley KL, Doomes EE, Drever RWP, Duke I, Dumas JC, Dwyer J, Echols C, Edgar M, Effler A, Ehrens P, Ely G, Espinoza E, Etzel T, Evans M, Evans T, Fairhurst S, Faltas Y, Fan Y, Fazi D, Fejer MM, Finn LS, Flasch K, Foley S, Forrest C, Fotopoulos N, Franzen A, Frei Z, Freise A, Frey R, Fricke TT, Fritschel P, Frolov VV, Fyffe M, Garofoli JA, Gholami I, Giaime JA, Giampanis S, Giardina KD, Goda K, Goetz E, Goggin LM, González G, Gossler S, Gouaty R, Grant A, Gras S, Gray C, Gray M, Greenhalgh RJS, Gretarsson AM, Grimaldi F, Grosso R, Grote H, Grunewald S, Guenther M, Gustafson EK, Gustafson R, Hage B, Hallam JM, Hanna C, Hanson J, Harms J, Harry GM, Harstad ED, Haughian E, Hayama K, Hayler T, Heefner J, Heng IS, Heptonstall A, Hewitson M, Hild S, Hirose E, Hoak D, Holt K, Hosken D, Hough J, Huttner SH, Ingram D, Ito M, Ivanov A, Johnson B, Johnson WW, Jones DI, Jones G, Jones R, Ju L, Kalmus P, Kalogera V, Kamat S, Kanner J, Kasprzyk D, Katsavounidis E, Kawabe K, Kawamura S, Kawazoe F, Kells W, Keppel DG, Khalaidovski A, Khalili FY, Khan R, Khazanov E, King P, Kissel JS, Klimenko S, Kocsis B, Kokeyama K, Kondrashov V, Kopparapu R, Koranda S, Kozak D, Kozhevatov I, Krishnan B, Kwee P, Landry M, Lantz B, Lazzarini A, Lei M, Leonor I, Li C, Lin H, Lindquist PE, Littenberg TB, Lockerbie NA, Lodhia D, Lormand M, Lu P, Lubinski M, Lucianetti A, Lück H, Machenschalk B, Macinnis M, Mageswaran M, Mailand K, Mandel I, Mandic V, Márka S, Márka Z, Markosyan A, Markowitz J, Maros E, Martin IW, Martin RM, Marx JN, Mason K, Matichard F, Matone L, Matzner R, Mavalvala N, McCarthy R, McClelland DE, McGuire SC, McHugh M, McIntyre G, McKechan D, McKenzie K, Mehmet M, Melissinos A, Mendell G, Mercer RA, Meshkov S, Messenger CJ, Meyers D, Miller A, Miller J, Minelli J, Mitra S, Mitrofanov VP, Mitselmakher G, Mittleman R, Miyakawa O, Moe B, Mohanty SD, Moreno G, Mors K, Mossavi K, Mowlowry C, Mueller G, Muhammad D, Mukherjee S, Mukhopadhyay H, Mullavey A, Müller-Ebhardt H, Munch J, Murray PG, Myers E, Myers J, Nash T, Nelson J, Newton G, Nishizawa A, Numata K, Ochsner E, O'Dell J, Ogin G, O'Reilly B, O'Shaughnessy R, Ottaway DJ, Ottens RS, Overmier H, Owen BJ, Pan Y, Pankow C, Papa MA, Parameshwaraiah V, Patel P, Pedraza M, Penn S, Perraca A, Petrie T, Pinto IM, Pitkin M, Pletsch HJ, Plissi MV, Postiglione F, Principe M, Prix R, Quetschke V, Raab FJ, Rabeling DS, Radkins H, Raffai P, Rainer N, Rakhmanov M, Ramsunder M, Reed T, Rehbein H, Reid S, Reitze DH, Riesen R, Riles K, Rivera B, Robertson NA, Robinson C, Robinson EL, Roddy S, Rogan AM, Rollins J, Romano JD, Romie JH, Rowan S, Rüdiger A, Ruet L, Russell P, Ryan K, Sakata S, Sancho de la Jordana L, Sandberg V, Sannibale V, Santamaria L, Saraf S, Sarin P, Sathyaprakash BS, Sato S, Saulson PR, Savage R, Savov P, Scanlan M, Schediwy SW, Schilling R, Schnabel R, Schofield R, Schutz BF, Schwinberg P, Scott J, Scott SM, Searle AC, Sears B, Seifert F, Sellers D, Sengupta AS, Sergeev A, Shapiro B, Shawhan P, Shoemaker DH, Sibley A, Siemens X, Sigg D, Sinha S, Sintes AM, Slagmolen BJJ, Slutsky J, Smith JR, Smith MR, Smith ND, Somiya K, Sorazu B, Stein LC, Strain KA, Stuver A, Summerscales TZ, Sun KX, Sung M, Sutton PJ, Takahashi H, Tanner DB, Taylor R, Taylor R, Thacker J, Thorne KA, Thorne KS, Thüring A, Tokmakov KV, Torres C, Torrie C, Traylor G, Trias M, Ugolini D, Urbanek K, Vahlbruch H, Van Den Broeck C, van der Sluys MV, van Veggel AA, Vass S, Vaulin R, Vecchio A, Veitch JD, Veitch P, Villar A, Vorvick C, Vyachanin SP, Waldman SJ, Wallace L, Ward H, Ward RL, Weinert M, Weinstein AJ, Weiss R, Wen L, Wen S, Wette K, Whelan JT, Whitcomb SE, Whiting BF, Wilkinson C, Willems PA, Williams HR, Williams L, Willke B, Wilmut I, Winkler W, Wipf CC, Wiseman AG, Woan G, Wooley R, Worden J, Wu W, Yakushin I, Yamamoto H, Yan Z, Yoshida S, Zanolin M, Zhang J, Zhang L, Zhao C, Zotov N, Zucker ME, Zur Mühlen H, Zweizig J. All-sky LIGO search for periodic gravitational waves in the early fifth-science-run data. Phys Rev Lett 2009; 102:111102. [PMID: 19392186 DOI: 10.1103/physrevlett.102.111102] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2008] [Indexed: 05/11/2023]
Abstract
We report on an all-sky search with the LIGO detectors for periodic gravitational waves in the frequency range 50-1100 Hz and with the frequency's time derivative in the range -5 x 10{-9}-0 Hz s{-1}. Data from the first eight months of the fifth LIGO science run (S5) have been used in this search, which is based on a semicoherent method (PowerFlux) of summing strain power. Observing no evidence of periodic gravitational radiation, we report 95% confidence-level upper limits on radiation emitted by any unknown isolated rotating neutron stars within the search range. Strain limits below 10{-24} are obtained over a 200-Hz band, and the sensitivity improvement over previous searches increases the spatial volume sampled by an average factor of about 100 over the entire search band. For a neutron star with nominal equatorial ellipticity of 10{-6}, the search is sensitive to distances as great as 500 pc.
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Affiliation(s)
- B P Abbott
- LIGO-California Institute of Technology, Pasadena, California 91125, USA
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Abbott BP, Abbott R, Adhikari R, Ajith P, Allen B, Allen G, Amin RS, Anderson SB, Anderson WG, Arain MA, Araya M, Armandula H, Armor P, Aso Y, Aston S, Aufmuth P, Aulbert C, Babak S, Baker P, Ballmer S, Bantilan H, Barish BC, Barker C, Barker D, Barr B, Barriga P, Barsotti L, Barton MA, Bartos I, Bassiri R, Bastarrika M, Behnke B, Benacquista M, Betzwieser J, Beyersdorf PT, Bilenko IA, Billingsley G, Biswas R, Black E, Blackburn JK, Blackburn L, Blair D, Bland B, Bodiya TP, Bogue L, Bork R, Boschi V, Bose S, Brady PR, Braginsky VB, Brau JE, Brinkmann M, Brooks AF, Brown DA, Brunet G, Bullington A, Buonanno A, Burmeister O, Byer RL, Cadonati L, Cagnoli G, Camp JB, Cannizzo J, Cannon KC, Cao J, Cardenas L, Cardoso V, Caride S, Casebolt T, Castaldi G, Caudill S, Cavaglià M, Cepeda C, Chalkley E, Charlton P, Chatterji S, Chelkowski S, Chen Y, Christensen N, Clark D, Clark J, Clayton JH, Cokelaer T, Conte R, Cook D, Corbitt TRC, Cornish N, Coyne DC, Creighton JDE, Creighton TD, Cruise AM, Cumming A, Cunningham L, Cutler RM, Danzmann K, Daudert B, Davies G, Debra D, Degallaix J, Dergachev V, Desai S, Desalvo R, Dhurandhar S, Díaz M, Dickson J, Dietz A, Donovan F, Dooley KL, Doomes EE, Drever RWP, Duke I, Dumas JC, Dwyer J, Echols C, Edgar M, Effler A, Ehrens P, Ely G, Espinoza E, Etzel T, Evans M, Evans T, Fairhurst S, Faltas Y, Fan Y, Fazi D, Fejer MM, Finn LS, Flasch K, Foley S, Forrest C, Fotopoulos N, Franzen A, Frei Z, Freise A, Frey R, Fricke TT, Fritschel P, Frolov VV, Fyffe M, Garofoli JA, Gholami I, Giaime JA, Giampanis S, Giardina KD, Goda K, Goetz E, Goggin LM, González G, Gossler S, Gouaty R, Grant A, Gras S, Gray C, Gray M, Greenhalgh RJS, Gretarsson AM, Grimaldi F, Grosso R, Grote H, Grunewald S, Guenther M, Gustafson EK, Gustafson R, Hage B, Hallam JM, Hanna C, Hanson J, Harms J, Harry GM, Harstad ED, Haughian E, Hayama K, Hayler T, Heefner J, Heng IS, Heptonstall A, Hewitson M, Hild S, Hirose E, Hoak D, Holt K, Hosken D, Hough J, Huttner SH, Ingram D, Ito M, Ivanov A, Johnson B, Johnson WW, Jones DI, Jones G, Jones R, Ju L, Kalmus P, Kalogera V, Kamat S, Kanner J, Kasprzyk D, Katsavounidis E, Kawabe K, Kawamura S, Kawazoe F, Kells W, Keppel DG, Khalaidovski A, Khalili FY, Khan R, Khazanov E, King P, Kissel JS, Klimenko S, Kocsis B, Kokeyama K, Kondrashov V, Kopparapu R, Koranda S, Kozak D, Kozhevatov I, Krishnan B, Kwee P, Landry M, Lantz B, Lazzarini A, Lei M, Leonor I, Li C, Lin H, Lindquist PE, Littenberg TB, Lockerbie NA, Lodhia D, Lormand M, Lu P, Lubinski M, Lucianetti A, Lück H, Machenschalk B, Macinnis M, Mageswaran M, Mailand K, Mandel I, Mandic V, Márka S, Márka Z, Markosyan A, Markowitz J, Maros E, Martin IW, Martin RM, Marx JN, Mason K, Matichard F, Matone L, Matzner R, Mavalvala N, McCarthy R, McClelland DE, McGuire SC, McHugh M, McIntyre G, McKechan D, McKenzie K, Mehmet M, Melissinos A, Mendell G, Mercer RA, Meshkov S, Messenger CJ, Meyers D, Miller A, Miller J, Minelli J, Mitra S, Mitrofanov VP, Mitselmakher G, Mittleman R, Miyakawa O, Moe B, Mohanty SD, Moreno G, Mors K, Mossavi K, Mowlowry C, Mueller G, Muhammad D, Mukherjee S, Mukhopadhyay H, Mullavey A, Müller-Ebhardt H, Munch J, Murray PG, Myers E, Myers J, Nash T, Nelson J, Newton G, Nishizawa A, Numata K, Ochsner E, O'Dell J, Ogin G, O'Reilly B, O'Shaughnessy R, Ottaway DJ, Ottens RS, Overmier H, Owen BJ, Pan Y, Pankow C, Papa MA, Parameshwaraiah V, Patel P, Pedraza M, Penn S, Perraca A, Petrie T, Pinto IM, Pitkin M, Pletsch HJ, Plissi MV, Postiglione F, Principe M, Prix R, Quetschke V, Raab FJ, Rabeling DS, Radkins H, Raffai P, Rainer N, Rakhmanov M, Ramsunder M, Reed T, Rehbein H, Reid S, Reitze DH, Riesen R, Riles K, Rivera B, Robertson NA, Robinson C, Robinson EL, Roddy S, Rogan AM, Rollins J, Romano JD, Romie JH, Rowan S, Rüdiger A, Ruet L, Russell P, Ryan K, Sakata S, Sancho de la Jordana L, Sandberg V, Sannibale V, Santamaria L, Saraf S, Sarin P, Sathyaprakash BS, Sato S, Saulson PR, Savage R, Savov P, Scanlan M, Schediwy SW, Schilling R, Schnabel R, Schofield R, Schutz BF, Schwinberg P, Scott J, Scott SM, Searle AC, Sears B, Seifert F, Sellers D, Sengupta AS, Sergeev A, Shapiro B, Shawhan P, Shoemaker DH, Sibley A, Siemens X, Sigg D, Sinha S, Sintes AM, Slagmolen BJJ, Slutsky J, Smith JR, Smith MR, Smith ND, Somiya K, Sorazu B, Stein LC, Strain KA, Stuver A, Summerscales TZ, Sun KX, Sung M, Sutton PJ, Takahashi H, Tanner DB, Taylor R, Taylor R, Thacker J, Thorne KA, Thorne KS, Thüring A, Tokmakov KV, Torres C, Torrie C, Traylor G, Trias M, Ugolini D, Urbanek K, Vahlbruch H, Van Den Broeck C, van der Sluys MV, van Veggel AA, Vass S, Vaulin R, Vecchio A, Veitch JD, Veitch P, Villar A, Vorvick C, Vyachanin SP, Waldman SJ, Wallace L, Ward H, Ward RL, Weinert M, Weinstein AJ, Weiss R, Wen L, Wen S, Wette K, Whelan JT, Whitcomb SE, Whiting BF, Wilkinson C, Willems PA, Williams HR, Williams L, Willke B, Wilmut I, Winkler W, Wipf CC, Wiseman AG, Woan G, Wooley R, Worden J, Wu W, Yakushin I, Yamamoto H, Yan Z, Yoshida S, Zanolin M, Zhang J, Zhang L, Zhao C, Zotov N, Zucker ME, Zur Mühlen H, Zweizig J. All-sky LIGO search for periodic gravitational waves in the early fifth-science-run data. Phys Rev Lett 2009. [PMID: 19392186 DOI: 10.1103/physrevd.80.042003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
We report on an all-sky search with the LIGO detectors for periodic gravitational waves in the frequency range 50-1100 Hz and with the frequency's time derivative in the range -5 x 10{-9}-0 Hz s{-1}. Data from the first eight months of the fifth LIGO science run (S5) have been used in this search, which is based on a semicoherent method (PowerFlux) of summing strain power. Observing no evidence of periodic gravitational radiation, we report 95% confidence-level upper limits on radiation emitted by any unknown isolated rotating neutron stars within the search range. Strain limits below 10{-24} are obtained over a 200-Hz band, and the sensitivity improvement over previous searches increases the spatial volume sampled by an average factor of about 100 over the entire search band. For a neutron star with nominal equatorial ellipticity of 10{-6}, the search is sensitive to distances as great as 500 pc.
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Affiliation(s)
- B P Abbott
- LIGO-California Institute of Technology, Pasadena, California 91125, USA
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Abbott BP, Abbott R, Adhikari R, Ajith P, Allen B, Allen G, Amin RS, Anderson SB, Anderson WG, Arain MA, Araya M, Armandula H, Armor P, Aso Y, Aston S, Aufmuth P, Aulbert C, Babak S, Baker P, Ballmer S, Bantilan H, Barish BC, Barker C, Barker D, Barr B, Barriga P, Barsotti L, Barton MA, Bartos I, Bassiri R, Bastarrika M, Behnke B, Benacquista M, Betzwieser J, Beyersdorf PT, Bilenko IA, Billingsley G, Biswas R, Black E, Blackburn JK, Blackburn L, Blair D, Bland B, Bodiya TP, Bogue L, Bork R, Boschi V, Bose S, Brady PR, Braginsky VB, Brau JE, Brinkmann M, Brooks AF, Brown DA, Brunet G, Bullington A, Buonanno A, Burmeister O, Byer RL, Cadonati L, Cagnoli G, Camp JB, Cannizzo J, Cannon KC, Cao J, Cardenas L, Cardoso V, Caride S, Casebolt T, Castaldi G, Caudill S, Cavaglià M, Cepeda C, Chalkley E, Charlton P, Chatterji S, Chelkowski S, Chen Y, Christensen N, Clark D, Clark J, Clayton JH, Cokelaer T, Conte R, Cook D, Corbitt TRC, Cornish N, Coyne DC, Creighton JDE, Creighton TD, Cruise AM, Cumming A, Cunningham L, Cutler RM, Danzmann K, Daudert B, Davies G, Debra D, Degallaix J, Dergachev V, Desai S, Desalvo R, Dhurandhar S, Díaz M, Dickson J, Dietz A, Donovan F, Dooley KL, Doomes EE, Drever RWP, Duke I, Dumas JC, Dwyer J, Echols C, Edgar M, Effler A, Ehrens P, Ely G, Espinoza E, Etzel T, Evans M, Evans T, Fairhurst S, Faltas Y, Fan Y, Fazi D, Fejer MM, Finn LS, Flasch K, Foley S, Forrest C, Fotopoulos N, Franzen A, Frei Z, Freise A, Frey R, Fricke TT, Fritschel P, Frolov VV, Fyffe M, Garofoli JA, Gholami I, Giaime JA, Giampanis S, Giardina KD, Goda K, Goetz E, Goggin LM, González G, Gossler S, Gouaty R, Grant A, Gras S, Gray C, Gray M, Greenhalgh RJS, Gretarsson AM, Grimaldi F, Grosso R, Grote H, Grunewald S, Guenther M, Gustafson EK, Gustafson R, Hage B, Hallam JM, Hanna C, Hanson J, Harms J, Harry GM, Harstad ED, Haughian E, Hayama K, Hayler T, Heefner J, Heng IS, Heptonstall A, Hewitson M, Hild S, Hirose E, Hoak D, Holt K, Hosken D, Hough J, Huttner SH, Ingram D, Ito M, Ivanov A, Johnson B, Johnson WW, Jones DI, Jones G, Jones R, Ju L, Kalmus P, Kalogera V, Kamat S, Kanner J, Kasprzyk D, Katsavounidis E, Kawabe K, Kawamura S, Kawazoe F, Kells W, Keppel DG, Khalaidovski A, Khalili FY, Khan R, Khazanov E, King P, Kissel JS, Klimenko S, Kocsis B, Kokeyama K, Kondrashov V, Kopparapu R, Koranda S, Kozak D, Kozhevatov I, Krishnan B, Kwee P, Landry M, Lantz B, Lazzarini A, Lei M, Leonor I, Li C, Lin H, Lindquist PE, Littenberg TB, Lockerbie NA, Lodhia D, Lormand M, Lu P, Lubinski M, Lucianetti A, Lück H, Machenschalk B, Macinnis M, Mageswaran M, Mailand K, Mandel I, Mandic V, Márka S, Márka Z, Markosyan A, Markowitz J, Maros E, Martin IW, Martin RM, Marx JN, Mason K, Matichard F, Matone L, Matzner R, Mavalvala N, McCarthy R, McClelland DE, McGuire SC, McHugh M, McIntyre G, McKechan D, McKenzie K, Mehmet M, Melissinos A, Mendell G, Mercer RA, Meshkov S, Messenger CJ, Meyers D, Miller A, Miller J, Minelli J, Mitra S, Mitrofanov VP, Mitselmakher G, Mittleman R, Miyakawa O, Moe B, Mohanty SD, Moreno G, Mors K, Mossavi K, Mowlowry C, Mueller G, Muhammad D, Mukherjee S, Mukhopadhyay H, Mullavey A, Müller-Ebhardt H, Munch J, Murray PG, Myers E, Myers J, Nash T, Nelson J, Newton G, Nishizawa A, Numata K, Ochsner E, O'Dell J, Ogin G, O'Reilly B, O'Shaughnessy R, Ottaway DJ, Ottens RS, Overmier H, Owen BJ, Pan Y, Pankow C, Papa MA, Parameshwaraiah V, Patel P, Pedraza M, Penn S, Perraca A, Petrie T, Pinto IM, Pitkin M, Pletsch HJ, Plissi MV, Postiglione F, Principe M, Prix R, Quetschke V, Raab FJ, Rabeling DS, Radkins H, Raffai P, Rainer N, Rakhmanov M, Ramsunder M, Reed T, Rehbein H, Reid S, Reitze DH, Riesen R, Riles K, Rivera B, Robertson NA, Robinson C, Robinson EL, Roddy S, Rogan AM, Rollins J, Romano JD, Romie JH, Rowan S, Rüdiger A, Ruet L, Russell P, Ryan K, Sakata S, Sancho de la Jordana L, Sandberg V, Sannibale V, Santamaria L, Saraf S, Sarin P, Sathyaprakash BS, Sato S, Saulson PR, Savage R, Savov P, Scanlan M, Schediwy SW, Schilling R, Schnabel R, Schofield R, Schutz BF, Schwinberg P, Scott J, Scott SM, Searle AC, Sears B, Seifert F, Sellers D, Sengupta AS, Sergeev A, Shapiro B, Shawhan P, Shoemaker DH, Sibley A, Siemens X, Sigg D, Sinha S, Sintes AM, Slagmolen BJJ, Slutsky J, Smith JR, Smith MR, Smith ND, Somiya K, Sorazu B, Stein LC, Strain KA, Stuver A, Summerscales TZ, Sun KX, Sung M, Sutton PJ, Takahashi H, Tanner DB, Taylor R, Taylor R, Thacker J, Thorne KA, Thorne KS, Thüring A, Tokmakov KV, Torres C, Torrie C, Traylor G, Trias M, Ugolini D, Urbanek K, Vahlbruch H, Van Den Broeck C, van der Sluys MV, van Veggel AA, Vass S, Vaulin R, Vecchio A, Veitch JD, Veitch P, Villar A, Vorvick C, Vyachanin SP, Waldman SJ, Wallace L, Ward H, Ward RL, Weinert M, Weinstein AJ, Weiss R, Wen L, Wen S, Wette K, Whelan JT, Whitcomb SE, Whiting BF, Wilkinson C, Willems PA, Williams HR, Williams L, Willke B, Wilmut I, Winkler W, Wipf CC, Wiseman AG, Woan G, Wooley R, Worden J, Wu W, Yakushin I, Yamamoto H, Yan Z, Yoshida S, Zanolin M, Zhang J, Zhang L, Zhao C, Zotov N, Zucker ME, Zur Mühlen H, Zweizig J. All-sky LIGO search for periodic gravitational waves in the early fifth-science-run data. Phys Rev Lett 2009. [PMID: 19392186 DOI: 10.1103/physrevd.79.022001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
We report on an all-sky search with the LIGO detectors for periodic gravitational waves in the frequency range 50-1100 Hz and with the frequency's time derivative in the range -5 x 10{-9}-0 Hz s{-1}. Data from the first eight months of the fifth LIGO science run (S5) have been used in this search, which is based on a semicoherent method (PowerFlux) of summing strain power. Observing no evidence of periodic gravitational radiation, we report 95% confidence-level upper limits on radiation emitted by any unknown isolated rotating neutron stars within the search range. Strain limits below 10{-24} are obtained over a 200-Hz band, and the sensitivity improvement over previous searches increases the spatial volume sampled by an average factor of about 100 over the entire search band. For a neutron star with nominal equatorial ellipticity of 10{-6}, the search is sensitive to distances as great as 500 pc.
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Affiliation(s)
- B P Abbott
- LIGO-California Institute of Technology, Pasadena, California 91125, USA
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Abbott BP, Abbott R, Adhikari R, Ajith P, Allen B, Allen G, Amin RS, Anderson SB, Anderson WG, Arain MA, Araya M, Armandula H, Armor P, Aso Y, Aston S, Aufmuth P, Aulbert C, Babak S, Baker P, Ballmer S, Bantilan H, Barish BC, Barker C, Barker D, Barr B, Barriga P, Barsotti L, Barton MA, Bartos I, Bassiri R, Bastarrika M, Behnke B, Benacquista M, Betzwieser J, Beyersdorf PT, Bilenko IA, Billingsley G, Biswas R, Black E, Blackburn JK, Blackburn L, Blair D, Bland B, Bodiya TP, Bogue L, Bork R, Boschi V, Bose S, Brady PR, Braginsky VB, Brau JE, Brinkmann M, Brooks AF, Brown DA, Brunet G, Bullington A, Buonanno A, Burmeister O, Byer RL, Cadonati L, Cagnoli G, Camp JB, Cannizzo J, Cannon KC, Cao J, Cardenas L, Cardoso V, Caride S, Casebolt T, Castaldi G, Caudill S, Cavaglià M, Cepeda C, Chalkley E, Charlton P, Chatterji S, Chelkowski S, Chen Y, Christensen N, Clark D, Clark J, Clayton JH, Cokelaer T, Conte R, Cook D, Corbitt TRC, Cornish N, Coyne DC, Creighton JDE, Creighton TD, Cruise AM, Cumming A, Cunningham L, Cutler RM, Danzmann K, Daudert B, Davies G, Debra D, Degallaix J, Dergachev V, Desai S, Desalvo R, Dhurandhar S, Díaz M, Dickson J, Dietz A, Donovan F, Dooley KL, Doomes EE, Drever RWP, Duke I, Dumas JC, Dwyer J, Echols C, Edgar M, Effler A, Ehrens P, Ely G, Espinoza E, Etzel T, Evans M, Evans T, Fairhurst S, Faltas Y, Fan Y, Fazi D, Fejer MM, Finn LS, Flasch K, Foley S, Forrest C, Fotopoulos N, Franzen A, Frei Z, Freise A, Frey R, Fricke TT, Fritschel P, Frolov VV, Fyffe M, Garofoli JA, Gholami I, Giaime JA, Giampanis S, Giardina KD, Goda K, Goetz E, Goggin LM, González G, Gossler S, Gouaty R, Grant A, Gras S, Gray C, Gray M, Greenhalgh RJS, Gretarsson AM, Grimaldi F, Grosso R, Grote H, Grunewald S, Guenther M, Gustafson EK, Gustafson R, Hage B, Hallam JM, Hanna C, Hanson J, Harms J, Harry GM, Harstad ED, Haughian E, Hayama K, Hayler T, Heefner J, Heng IS, Heptonstall A, Hewitson M, Hild S, Hirose E, Hoak D, Holt K, Hosken D, Hough J, Huttner SH, Ingram D, Ito M, Ivanov A, Johnson B, Johnson WW, Jones DI, Jones G, Jones R, Ju L, Kalmus P, Kalogera V, Kamat S, Kanner J, Kasprzyk D, Katsavounidis E, Kawabe K, Kawamura S, Kawazoe F, Kells W, Keppel DG, Khalaidovski A, Khalili FY, Khan R, Khazanov E, King P, Kissel JS, Klimenko S, Kocsis B, Kokeyama K, Kondrashov V, Kopparapu R, Koranda S, Kozak D, Kozhevatov I, Krishnan B, Kwee P, Landry M, Lantz B, Lazzarini A, Lei M, Leonor I, Li C, Lin H, Lindquist PE, Littenberg TB, Lockerbie NA, Lodhia D, Lormand M, Lu P, Lubinski M, Lucianetti A, Lück H, Machenschalk B, Macinnis M, Mageswaran M, Mailand K, Mandel I, Mandic V, Márka S, Márka Z, Markosyan A, Markowitz J, Maros E, Martin IW, Martin RM, Marx JN, Mason K, Matichard F, Matone L, Matzner R, Mavalvala N, McCarthy R, McClelland DE, McGuire SC, McHugh M, McIntyre G, McKechan D, McKenzie K, Mehmet M, Melissinos A, Mendell G, Mercer RA, Meshkov S, Messenger CJ, Meyers D, Miller A, Miller J, Minelli J, Mitra S, Mitrofanov VP, Mitselmakher G, Mittleman R, Miyakawa O, Moe B, Mohanty SD, Moreno G, Mors K, Mossavi K, Mowlowry C, Mueller G, Muhammad D, Mukherjee S, Mukhopadhyay H, Mullavey A, Müller-Ebhardt H, Munch J, Murray PG, Myers E, Myers J, Nash T, Nelson J, Newton G, Nishizawa A, Numata K, Ochsner E, O'Dell J, Ogin G, O'Reilly B, O'Shaughnessy R, Ottaway DJ, Ottens RS, Overmier H, Owen BJ, Pan Y, Pankow C, Papa MA, Parameshwaraiah V, Patel P, Pedraza M, Penn S, Perraca A, Petrie T, Pinto IM, Pitkin M, Pletsch HJ, Plissi MV, Postiglione F, Principe M, Prix R, Quetschke V, Raab FJ, Rabeling DS, Radkins H, Raffai P, Rainer N, Rakhmanov M, Ramsunder M, Reed T, Rehbein H, Reid S, Reitze DH, Riesen R, Riles K, Rivera B, Robertson NA, Robinson C, Robinson EL, Roddy S, Rogan AM, Rollins J, Romano JD, Romie JH, Rowan S, Rüdiger A, Ruet L, Russell P, Ryan K, Sakata S, Sancho de la Jordana L, Sandberg V, Sannibale V, Santamaria L, Saraf S, Sarin P, Sathyaprakash BS, Sato S, Saulson PR, Savage R, Savov P, Scanlan M, Schediwy SW, Schilling R, Schnabel R, Schofield R, Schutz BF, Schwinberg P, Scott J, Scott SM, Searle AC, Sears B, Seifert F, Sellers D, Sengupta AS, Sergeev A, Shapiro B, Shawhan P, Shoemaker DH, Sibley A, Siemens X, Sigg D, Sinha S, Sintes AM, Slagmolen BJJ, Slutsky J, Smith JR, Smith MR, Smith ND, Somiya K, Sorazu B, Stein LC, Strain KA, Stuver A, Summerscales TZ, Sun KX, Sung M, Sutton PJ, Takahashi H, Tanner DB, Taylor R, Taylor R, Thacker J, Thorne KA, Thorne KS, Thüring A, Tokmakov KV, Torres C, Torrie C, Traylor G, Trias M, Ugolini D, Urbanek K, Vahlbruch H, Van Den Broeck C, van der Sluys MV, van Veggel AA, Vass S, Vaulin R, Vecchio A, Veitch JD, Veitch P, Villar A, Vorvick C, Vyachanin SP, Waldman SJ, Wallace L, Ward H, Ward RL, Weinert M, Weinstein AJ, Weiss R, Wen L, Wen S, Wette K, Whelan JT, Whitcomb SE, Whiting BF, Wilkinson C, Willems PA, Williams HR, Williams L, Willke B, Wilmut I, Winkler W, Wipf CC, Wiseman AG, Woan G, Wooley R, Worden J, Wu W, Yakushin I, Yamamoto H, Yan Z, Yoshida S, Zanolin M, Zhang J, Zhang L, Zhao C, Zotov N, Zucker ME, Zur Mühlen H, Zweizig J. All-sky LIGO search for periodic gravitational waves in the early fifth-science-run data. Phys Rev Lett 2009. [PMID: 19392186 DOI: 10.1103/physrevd.77.022001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
We report on an all-sky search with the LIGO detectors for periodic gravitational waves in the frequency range 50-1100 Hz and with the frequency's time derivative in the range -5 x 10{-9}-0 Hz s{-1}. Data from the first eight months of the fifth LIGO science run (S5) have been used in this search, which is based on a semicoherent method (PowerFlux) of summing strain power. Observing no evidence of periodic gravitational radiation, we report 95% confidence-level upper limits on radiation emitted by any unknown isolated rotating neutron stars within the search range. Strain limits below 10{-24} are obtained over a 200-Hz band, and the sensitivity improvement over previous searches increases the spatial volume sampled by an average factor of about 100 over the entire search band. For a neutron star with nominal equatorial ellipticity of 10{-6}, the search is sensitive to distances as great as 500 pc.
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Affiliation(s)
- B P Abbott
- LIGO-California Institute of Technology, Pasadena, California 91125, USA
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Tracie Shea M, Edelen MO, Pinto A, Yen S, Gunderson JG, Skodol AE, Markowitz J, Sanislow CA, Grilo CM, Ansell E, Daversa MT, Zanarini MC, McGlashan TH, Morey LC. Improvement in borderline personality disorder in relationship to age. Acta Psychiatr Scand 2009; 119:143-8. [PMID: 18851719 PMCID: PMC2629076 DOI: 10.1111/j.1600-0447.2008.01274.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE It is commonly believed that some features of borderline personality disorder (BPD) improve as individuals reach their late 30s and 40s. This study examined age-related change in borderline criteria and functional impairment, testing the hypothesis that older age would be associated with relatively more improvement than younger age. METHOD A total of 216 male and female participants with BPD were followed prospectively with yearly assessments over 6 years. RESULTS Participants showed similar rates of improvement in borderline features regardless of age. A significant age by study year interaction showed functioning in older subjects to reverse direction and begin to decline in the latter part of the follow-up, in contrast to younger subjects who maintained or continued improvement over the 6 years. Despite the decline, functioning for the older subjects was comparable with or slightly better at year 6 than at year 1. CONCLUSION Improvement in borderline features is not specific to the late 30s and 40s. There may be a reversal of improvement in functioning in some borderline patients in this older-age range.
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Affiliation(s)
- M Tracie Shea
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI 02906, USA.
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Abbott B, Abbott R, Adhikari R, Ajith P, Allen B, Allen G, Amin R, Anderson SB, Anderson WG, Arain MA, Araya M, Armandula H, Armor P, Aso Y, Aston S, Aufmuth P, Aulbert C, Babak S, Ballmer S, Bantilan H, Barish BC, Barker C, Barker D, Barr B, Barriga P, Barton MA, Bartos I, Bastarrika M, Bayer K, Betzwieser J, Beyersdorf PT, Bilenko IA, Billingsley G, Biswas R, Black E, Blackburn K, Blackburn L, Blair D, Bland B, Bodiya TP, Bogue L, Bork R, Boschi V, Bose S, Brady PR, Braginsky VB, Brau JE, Brinkmann M, Brooks A, Brown DA, Brunet G, Bullington A, Buonanno A, Burmeister O, Byer RL, Cadonati L, Cagnoli G, Camp JB, Cannizzo J, Cannon K, Cao J, Cardenas L, Casebolt T, Castaldi G, Cepeda C, Chalkley E, Charlton P, Chatterji S, Chelkowski S, Chen Y, Christensen N, Clark D, Clark J, Cokelaer T, Conte R, Cook D, Corbitt T, Coyne D, Creighton JDE, Cumming A, Cunningham L, Cutler RM, Dalrymple J, Danzmann K, Davies G, Debra D, Degallaix J, Degree M, Dergachev V, Desai S, Desalvo R, Dhurandhar S, Díaz M, Dickson J, Dietz A, Donovan F, Dooley KL, Doomes EE, Drever RWP, Duke I, Dumas JC, Dupuis RJ, Dwyer JG, Echols C, Effler A, Ehrens P, Espinoza E, Etzel T, Evans T, Fairhurst S, Fan Y, Fazi D, Fehrmann H, Fejer MM, Finn LS, Flasch K, Fotopoulos N, Freise A, Frey R, Fricke T, Fritschel P, Frolov VV, Fyffe M, Garofoli J, Gholami I, Giaime JA, Giampanis S, Giardina KD, Goda K, Goetz E, Goggin L, González G, Gossler S, Gouaty R, Grant A, Gras S, Gray C, Gray M, Greenhalgh RJS, Gretarsson AM, Grimaldi F, Grosso R, Grote H, Grunewald S, Guenther M, Gustafson EK, Gustafson R, Hage B, Hallam JM, Hammer D, Hanna C, Hanson J, Harms J, Harry G, Harstad E, Hayama K, Hayler T, Heefner J, Heng IS, Hennessy M, Heptonstall A, Hewitson M, Hild S, Hirose E, Hoak D, Hosken D, Hough J, Huttner SH, Ingram D, Ito M, Ivanov A, Johnson B, Johnson WW, Jones DI, Jones G, Jones R, Ju L, Kalmus P, Kalogera V, Kamat S, Kanner J, Kasprzyk D, Katsavounidis E, Kawabe K, Kawamura S, Kawazoe F, Kells W, Keppel DG, Khalili FY, Khan R, Khazanov E, Kim C, King P, Kissel JS, Klimenko S, Kokeyama K, Kondrashov V, Kopparapu RK, Kozak D, Kozhevatov I, Krishnan B, Kwee P, Lam PK, Landry M, Lang MM, Lantz B, Lazzarini A, Lei M, Leindecker N, Leonhardt V, Leonor I, Libbrecht K, Lin H, Lindquist P, Lockerbie NA, Lodhia D, Lormand M, Lu P, Lubinski M, Lucianetti A, Lück H, Machenschalk B, Macinnis M, Mageswaran M, Mailand K, Mandic V, Márka S, Márka Z, Markosyan A, Markowitz J, Maros E, Martin I, Martin RM, Marx JN, Mason K, Matichard F, Matone L, Matzner R, Mavalvala N, McCarthy R, McClelland DE, McGuire SC, McHugh M, McIntyre G, McIvor G, McKechan D, McKenzie K, Meier T, Melissinos A, Mendell G, Mercer RA, Meshkov S, Messenger CJ, Meyers D, Miller J, Minelli J, Mitra S, Mitrofanov VP, Mitselmakher G, Mittleman R, Miyakawa O, Moe B, Mohanty S, Moreno G, Mossavi K, Mowlowry C, Mueller G, Mukherjee S, Mukhopadhyay H, Müller-Ebhardt H, Munch J, Murray P, Myers E, Myers J, Nash T, Nelson J, Newton G, Nishizawa A, Numata K, O'Dell J, Ogin G, O'Reilly B, O'Shaughnessy R, Ottaway DJ, Ottens RS, Overmier H, Owen BJ, Pan Y, Pankow C, Papa MA, Parameshwaraiah V, Patel P, Pedraza M, Penn S, Perreca A, Petrie T, Pinto IM, Pitkin M, Pletsch HJ, Plissi MV, Postiglione F, Principe M, Prix R, Quetschke V, Raab F, Rabeling DS, Radkins H, Rainer N, Rakhmanov M, Ramsunder M, Rehbein H, Reid S, Reitze DH, Riesen R, Riles K, Rivera B, Robertson NA, Robinson C, Robinson EL, Roddy S, Rodriguez A, Rogan AM, Rollins J, Romano JD, Romie J, Route R, Rowan S, Rüdiger A, Ruet L, Russell P, Ryan K, Sakata S, Samidi M, de la Jordana LS, Sandberg V, Sannibale V, Saraf S, Sarin P, Sathyaprakash BS, Sato S, Saulson PR, Savage R, Savov P, Schediwy SW, Schilling R, Schnabel R, Schofield R, Schutz BF, Schwinberg P, Scott SM, Searle AC, Sears B, Seifert F, Sellers D, Sengupta AS, Shawhan P, Shoemaker DH, Sibley A, Siemens X, Sigg D, Sinha S, Sintes AM, Slagmolen BJJ, Slutsky J, Smith JR, Smith MR, Smith ND, Somiya K, Sorazu B, Stein LC, Stochino A, Stone R, Strain KA, Strom DM, Stuver A, Summerscales TZ, Sun KX, Sung M, Sutton PJ, Takahashi H, Tanner DB, Taylor R, Taylor R, Thacker J, Thorne KA, Thorne KS, Thüring A, Tokmakov KV, Torres C, Torrie C, Traylor G, Trias M, Tyler W, Ugolini D, Ulmen J, Urbanek K, Vahlbruch H, Van Den Broeck C, van der Sluys M, Vass S, Vaulin R, Vecchio A, Veitch J, Veitch P, Villar A, Vorvick C, Vyachanin SP, Waldman SJ, Wallace L, Ward H, Ward R, Weinert M, Weinstein A, Weiss R, Wen S, Wette K, Whelan JT, Whitcomb SE, Whiting BF, Wilkinson C, Willems PA, Williams HR, Williams L, Willke B, Wilmut I, Winkler W, Wipf CC, Wiseman AG, Woan G, Wooley R, Worden J, Wu W, Yakushin I, Yamamoto H, Yan Z, Yoshida S, Zanolin M, Zhang J, Zhang L, Zhao C, Zotov N, Zucker M, Zweizig J, Barthelmy S, Gehrels N, Hurley KC, Palmer D. Search for gravitational-wave bursts from soft gamma repeaters. Phys Rev Lett 2008; 101:211102. [PMID: 19113401 DOI: 10.1103/physrevlett.101.211102] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2008] [Indexed: 05/11/2023]
Abstract
We present a LIGO search for short-duration gravitational waves (GWs) associated with soft gamma ray repeater (SGR) bursts. This is the first search sensitive to neutron star f modes, usually considered the most efficient GW emitting modes. We find no evidence of GWs associated with any SGR burst in a sample consisting of the 27 Dec. 2004 giant flare from SGR 1806-20 and 190 lesser events from SGR 1806-20 and SGR 1900+14. The unprecedented sensitivity of the detectors allows us to set the most stringent limits on transient GW amplitudes published to date. We find upper limit estimates on the model-dependent isotropic GW emission energies (at a nominal distance of 10 kpc) between 3x10;{45} and 9x10;{52} erg depending on waveform type, detector antenna factors and noise characteristics at the time of the burst. These upper limits are within the theoretically predicted range of some SGR models.
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Affiliation(s)
- B Abbott
- LIGO-California Institute of Technology, Pasadena, California 91125, USA
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Grossman AB, Markowitz J, Loomes KM, Mamula P. A 12-year-old boy with progressive dysphagia. Medscape J Med 2008; 10:248. [PMID: 19099042 PMCID: PMC2605130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- Andrew B Grossman
- Division of GI, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Pennsylvania, USA.
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de Zoeten EF, Markowitz J, Loomes KM, Mamula P, Piccoli DA. A 9-month-old girl with chronic diarrhea. Medscape J Med 2008; 10:195. [PMID: 18924647 PMCID: PMC2562142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Edwin F. de Zoeten
- University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania Author's
| | - Jonathan Markowitz
- University of South Carolina School of Medicine, Columbia, South Carolina; Children's Center for Digestive Health, Greenville Hospital System University Medical Center, Greenville, South Carolina Author's
| | - Kathleen M. Loomes
- University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Petar Mamula
- Endoscopy Suite, Division of Gastroenterology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - David A. Piccoli
- Division of Gastroenterology, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
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Abstract
Children with inflammatory bowel disease present formidable therapeutic challenges. As both Crohn's disease and ulcerative colitis remain medically incurable conditions associated with potentially significant morbidity, the focus of treatment must be to reduce or eliminate symptoms, optimize nutritional status, promote normal growth and development, prevent complications and minimize the potential psychological effects of these chronic illnesses. This review focuses on the evidence supporting the treatments currently used in children with inflammatory bowel disease, and suggests potential treatment algorithms for particular clinical circumstances.
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Affiliation(s)
- J Markowitz
- NYU School of Medicine, Division of Pediatric Gastroenterology, Schneider Children's Hospital, North Shore-Long Island Jewish Health System, New Hyde Park, NY, USA.
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Cathcart EP, Markowitz J. The influence of various sugars on the respiratory quotient: A contribution to the significance of the R.Q. J Physiol 2007; 63:309-24. [PMID: 16993892 PMCID: PMC1514945 DOI: 10.1113/jphysiol.1927.sp002406] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Affiliation(s)
- E P Cathcart
- The Institute of Physiology, The University of Glasgow
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Jacobstein D, Markowitz J, Mamula P. A 2-month-old with persistent diarrhea. MedGenMed 2005; 7:13. [PMID: 16369318 PMCID: PMC1681397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- Douglas Jacobstein
- Division of Gastroenterology & Nutrition, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
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Weber D, Markowitz J, MacKerell A, Carrier F. 72 Restoration of wild-type p53 in malignant melanoma. EJC Suppl 2004. [DOI: 10.1016/s1359-6349(04)80080-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Brown KA, Back SJ, Ruchelli ED, Markowitz J, Mascarenhas M, Verma R, Piccoli DA, Baldassano RN. Lamina propria and circulating interleukin-6 in newly diagnosed pediatric inflammatory bowel disease patients. Am J Gastroenterol 2002; 97:2603-8. [PMID: 12385446 DOI: 10.1111/j.1572-0241.2002.06030.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Understanding cytokine production patterns in early mucosal lesions of pediatric patients newly diagnosed with inflammatory bowel disease (IBD) may be critical to understanding IBD pathogenesis. Interleukin-6 (IL-6) has a central role in a multitude of immune system reactions; however, inconsistent lamina propria and serum IL-6 has been reported in IBD patients. Newly diagnosed pediatric IBD patients have not previously been evaluated for lamina propria or serum IL-6. METHODS Serum and intestinal lamina propria biopsy whole organ culture supernatants were evaluated by ELISA for IL-6 obtained from newly diagnosed IBD patients, before initiation of immunomodulatory therapies. RESULTS Levels of lamina propria IL-6 demonstrated significant correlation with graded severity of histological inflammation (p < 0.001). Log-transformed serum and organ culture IL-6 levels demonstrated significant correlation (p < 0.0001, R2 = 0.6226). Assigning a demarcation level of >400 pg/ml, serum IL-6 concentrations were a superior marker for the presence of microscopic intestinal inflammation than erythrocyte sedimentation rate (ESR), with a sensitivity of 82%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 82%. When evaluating subtypes of IBD, serum IL-6 levels were correlated more significantly with active disease in ulcerative colitis patients (p = 0.01, R2 = 0.74) than in Crohn's disease patients (p = 0.21, R2 = 0.33). CONCLUSIONS This study outlines graded production of IL-6 in intestinal lamina propria and serum of newly diagnosed pediatric IBD patients, confirming the presence of IL-6 in early IBD patients. In addition, serum IL-6 may be a good predictor of IBD in pediatric patients with suspected or newly diagnosed IBD.
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Affiliation(s)
- Kurt A Brown
- Division of Gastroenterology and Nutrition, The Children's Hospital of Philadelphia, Pennsylvania 19104, USA
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Abstract
The literature of the past year has produced significant advances relevant to the diagnosis and treatment of children and adolescents with inflammatory bowel disease. This review focuses on new observations regarding the epidemiology, genetics, etiology, diagnosis, and treatment of both Crohn's disease and ulcerative colitis in children. Particular attention is paid to the expanded indications for the use of immunomodulatory therapy, and to the early published data regarding the safety and efficacy of treatment with infliximab.
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Affiliation(s)
- C Haller
- Division of Pediatric Gastroenterology and Nutrition, North Shore University Hospital, 300 Community Drive, Manhasset, NY 11030, USA.
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Montgomery RA, Kavoussi LR, Su L, Sinkov V, Cohen C, Maley WR, Burdick JF, Markowitz J, Ratner LE. Improved recipient results after 5 years of performing laparoscopic donor nephrectomy. Transplant Proc 2001; 33:1108-10. [PMID: 11267212 DOI: 10.1016/s0041-1345(00)02436-2] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- R A Montgomery
- Departments of Surgery and Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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