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Harris AB, Root KT, Cueto R, Diaz MJ, Zhao A, Oni JK, Hegde V, Khanuja HS. The Definition of Anemia Matters When Using Preoperative Hemoglobin as a Screening Tool Prior to Total Hip and Knee Arthroplasty. J Arthroplasty 2024; 39:1240-1244. [PMID: 37939888 DOI: 10.1016/j.arth.2023.10.059] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 10/29/2023] [Accepted: 10/30/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Preoperative anemia is common in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). Several definitions of anemia have been described, with no clear consensus on the optimal one for preoperative screening. We hypothesized that depending on the definition used preoperatively, the proportion of anemic patients identified who would require a postoperative allogeneic blood transfusion would vary significantly. METHODS A total of 681,141 patients were identified in a national database who underwent either THA or TKA. Preoperative anemia was classified according to the World Health Organization (WHO) definition, Cleveland Clinic (CC) definition, or race, age, and sex-specific definition described by Beutler et al in 2006. The optimal preoperative (OP) hemoglobin thresholds to predict perioperative transfusions were also calculated using receiver operating characteristic curves. RESULTS When using the WHO definition, 18% of anemic patients required a transfusion versus 14% (OP definition), 12% (CC definition), and 16% (Beutler definition). Similarly, 0.69% of anemic patients sustained a periprosthetic joint infection within 30 days using the WHO definition versus 0.59% (OP definition), 0.60% (CC definition), or 0.66% (Beutler definition). Using the WHO definition, 5.3% of patients would have sustained a major complication versus 4.5% (OP definition), 4.4% (CC definition), and 5.0% (Beutler definition). CONCLUSIONS Variation in the definition of anemia for preoperative screening in THA and TKA results in substantial differences in discriminative ability to predict perioperative transfusions. The WHO definition identified the largest proportion of patients who ultimately received a perioperative transfusion.
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Affiliation(s)
- Andrew B Harris
- Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland
| | - Kevin T Root
- University of Florida College of Medicine, Gainesville, Florida
| | - Robert Cueto
- University of Florida College of Medicine, Gainesville, Florida
| | - Michael J Diaz
- University of Florida College of Medicine, Gainesville, Florida
| | - Amy Zhao
- The George Washington University College of Medicine, Washington, District of Columbia
| | - Julius K Oni
- Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland
| | - Vishal Hegde
- Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland
| | - Harpal S Khanuja
- Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland
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Root KT, Burnett AJ, Kakalecik J, Harris AB, Ladehoff L, Taneja K, Patrick MR, Hagen JE, King JJ. The Association between Race and Extended Length of Stay in Low-energy Proximal Humerus Fractures in Elderly Patients. J Am Acad Orthop Surg 2024:00124635-990000000-00923. [PMID: 38595161 DOI: 10.5435/jaaos-d-23-00925] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 02/19/2024] [Indexed: 04/11/2024] Open
Abstract
INTRODUCTION Proximal humerus fractures (PHFs) are one of the most common fractures among patients aged 65 years and older, commonly due to low-energy mechanisms. It is essential to identify drivers of increased healthcare utilization in geriatric PHF patients and bring awareness to any disparities in care. Here, we identify factors associated with the likelihood of inpatient admission and prolonged hospital stay among patients aged 65 years and older who sustain PHF due to falls. METHODS A national database was used to identify patients aged 65 years and older who suffered proximal humeral fractures due to a fall. Patient factors were analyzed for association with the likelihood of admission and odds of prolonged stay (≥5 days). RESULTS In the study period, 75,385 PHF patients who met our inclusion criteria presented to the emergency department and 14,118 (18.7%) were admitted. Black race was significantly associated with decreased odds of admission (P < 0.001) and increased likelihood of prolonged stay (P = 0.007) compared with White patients. Patients aged 75 to 84 and 85+ were both more likely to be admitted (P < 0.001) and experienced a prolonged hospital stay (P = 0.015). Patients undergoing surgical intervention with reverse total shoulder arthroplasty were associated with admission and prolonged length of stay (P < 0.001). Hospitals in Midwestern (P < 0.001) and Western (P < 0.001) regions exhibited lower rates of admission and Northeastern hospitals were associated with prolonged stays (P = 0.001). Finally, trauma and nonmetropolitan (P < 0.001) centers were associated with admission. CONCLUSION Our study highlights the notable influence of age and race on the likelihood of hospital admission and prolonged hospital stay. Specifically, Black patients exhibited prolonged hospital stay, which has been associated with lower-quality care, warranting additional exploration. Understanding these demographic and hospital-related factors is essential for optimizing resource allocation and reducing healthcare disparities in the care of PHF patients, especially as the population ages and the incidence of PHF continues to rise.
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Affiliation(s)
- Kevin T Root
- From the College of Medicine, University of Florida, Gainesville, FL (Root and Burnett), Department of Orthopaedic Surgery, University of Florida, Gainesville, FL (Kakalecik, Patrick, Hagen, and King), the Department of Orthopaedic Surgery, Johns Hopkins, Baltimore, MD (Harris), USF Health Morsani College of Medicine, Tampa, FL (Ladehoff), and Renaissance School of Medicine at Stony Brook University, Stony Brook, NY (Taneja)
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Jackson NJ, Root KT, Nichols JA, Reb CW. Image Rotation Alters Apparent Fibula Length: An Evaluation of Talocrural Angle, Shenton Line, and Dime Sign. Foot Ankle Int 2024; 45:236-242. [PMID: 38240153 DOI: 10.1177/10711007231221991] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2024]
Abstract
BACKGROUND Fibula shortening can compromise ankle stability and force transmission, thereby impacting clinical outcomes. Because radiographs depict 3-dimensional anatomy in 2 dimensions, accurate radiographic assessment of fibula length is a commonly encountered clinical challenge. The talocrural angle (TCA), Shenton line, and dime sign are useful parameters of fibula length. Yet, the impact of 3-dimensional limb positioning on these radiographic parameters is not established. METHODS Bone models were constructed from CT scans of 30 lower limbs. Fibula length was computationally manipulated, and digitally reconstructed radiographs were generated reflecting 1-degree increments of sagittal and axial plane rotation of each limb for each fibula length condition. The TCA was computationally measured on each image. The presence of an aligned mortise view, intact Shenton line, and intact dime sign was assessed by 2 observers. RESULTS The mean TCA, which was 78.0 (95% CI ± 1.6) degrees for a true mortise projection with anatomic fibula length, changed by approximately 1 degree per millimeter of fibula length change. On average, 14.7 degrees of caudal rotation obscured 2 mm of fibular shortening by virtue of producing the same TCA as a true mortise view with anatomic fibula length, designated a false positive view. Axial rotation had a comparatively small effect. Observers 1 and 2 were, respectively, 91% and 88% less likely to accurately judge the image alignment of the false positive images compared to true mortise images. Moreover, intraobserver agreement was poor to moderate (mean 0.47, range 0.13-0.59) and interobserver agreement was uniformly poor (mean 0.08, range 0.01-0.20). CONCLUSION In our study using digitally reconstructed radiographs from CT scans of 30 limbs, we found that sagittal plane rotation impacts the radiographic appearance of fibula length as measured by the TCA. Limb axial rotation had a comparatively small effect. Further study of human perception of Shenton line and dime sign is needed before the effect of rotation on these parameters can be fully understood. LEVEL OF EVIDENCE Level IV, case series.
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Affiliation(s)
- Nicholas J Jackson
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Kevin T Root
- College of Medicine, University of Florida, Gainesville, FL, USA
| | - Jennifer A Nichols
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
- Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, FL, USA
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Root KT, Harris AB, Ladehoff LC, Cueto RJ, Diaz MJ, Oni JK. Publishing on Topical Subjects in Total Joint Arthroplasty Is Associated With Increased Social Media Attention. J Arthroplasty 2024; 39:290-294. [PMID: 37574031 DOI: 10.1016/j.arth.2023.08.021] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 08/03/2023] [Accepted: 08/05/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND Social media platforms are often used for research dissemination and collaboration. Given the increased prevalence of online-only publications, understanding what drives research dissemination is important. Here, we analyzed factors associated with increased social media attention among peer-reviewed publications in total knee arthroplasty, total hip arthroplasty, and unicompartmental knee arthroplasty. METHODS We analyzed publications about total knee arthroplasty, total hip arthroplasty, or unicompartmental knee arthroplasty from 2010 to 2022 using a national database. We analyzed a weighted count of social media mentions, using negative binomial regressions adjusting for days since publication. Publications on "hot topics" in arthroplasty were examined including navigation/robotics, COVID-19, race/ethnicity, body mass index, and reimbursement. There were 9,542 publications included, 4,216 (44%) were open access (OA), 338 (3.5%) included navigation, 32 (0.34%) discussed race/ethnicity, 20 (0.2%) discussed COVID-19, 3,840 (40%) were randomized studies, 30 (0.3%) discussed reimbursement, and 2,867 (30%) were in top-10 orthopaedic journals. RESULTS Factors associated with higher weighted score included studies about COVID-19 (50 versus 6.0, P < .001), race/ethnicity (15.8 versus 6.0, P < .001), OA status (6.3 versus 5.8, P = .001), and randomized studies (6.5 versus 5.7, P < .001). Studies from top-10 journals had a lower score (5.8 versus 6.2, P = .025), as did studies about body mass index (3.4 versus 6.1, P = .001). Studies about navigation and reimbursement did not have significantly different scores. CONCLUSIONS Studies on COVID-19, race/ethnicity, randomized studies, and OA publication were associated with increased social media while those in top-10 orthopaedic journals had lower scores. LEVEL OF EVIDENCE Level IV, Prognostic Study.
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Affiliation(s)
- Kevin T Root
- College of Medicine, University of Florida, Gainesville, Florida
| | - Andrew B Harris
- Department of Orthopaedic Surgery, Johns Hopkins, Baltimore, Maryland
| | | | - Robert J Cueto
- College of Medicine, University of Florida, Gainesville, Florida
| | - Michael J Diaz
- College of Medicine, University of Florida, Gainesville, Florida
| | - Julius K Oni
- Department of Orthopaedic Surgery, Johns Hopkins, Baltimore, Maryland
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Diaz MJ, Tran JT, Choo ZN, Root KT, Batchu S, Milanovic S, Ladehoff L, Fadil A, Lipner SR. Genomic subtypes of cutaneous melanoma have distinct metabolic profiles: A single-cell transcriptomic analysis. Arch Dermatol Res 2023; 315:2961-2965. [PMID: 37658915 DOI: 10.1007/s00403-023-02690-7] [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] [Received: 06/18/2023] [Revised: 06/18/2023] [Accepted: 07/27/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVE Genomic profiling previously classified melanoma into distinct subtypes based on the presence or absence of mutations in driver genes, but metabolic differences between and within these groups have yet to be thoroughly analyzed. Thus, the objective of the present study is to provide the first effort to holistically characterize the metabolic landscape of qualified melanoma genomic subtypes at single-cell resolution. METHODS Expression data for a total of 1145 malignant cells sourced from NRAS(Q61L), BRAF(V600E), and NRAS/BRAF WT melanomas were retrieved from the Broad Single Cell Portal. Metabolic activity was interrogated by pathway scoring and gene set enrichment analysis. RESULTS A total of 53 metabolic pathways were differentially regulated in at least one melanoma genomic subtype. Some notable findings include: BRAF/NRAS WT cells were enriched for fatty acid biosynthesis and depleted for metabolism of alanine, aspartate, and glutamate; BRAF(V600E) melanoma cells were enriched for beta-alanine metabolism and depleted for phenylalanine metabolism; NRAS(Q61L) melanoma cells were enriched for steroid biosynthesis and depleted for linoleic acid metabolism. CONCLUSION Primary limitations include the total quantity of single cells and breadth of available genomic subtypes plus inherent noisiness of the applied methodologies. Nonetheless, these findings nominate novel, testable therapeutic targets.
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Affiliation(s)
- Michael J Diaz
- College of Medicine, University of Florida, Gainesville, FL, USA.
| | - Jasmine T Tran
- School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Zi-Ning Choo
- Medical College, Weill Cornell Medicine, New York, NY, USA
| | - Kevin T Root
- College of Medicine, University of Florida, Gainesville, FL, USA
| | - Sai Batchu
- Cooper Medical School, Rowan University, Camden, NJ, USA
| | | | - Lauren Ladehoff
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Angela Fadil
- College of Medicine, University of Florida, Gainesville, FL, USA
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, NY, USA
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Cerillo JL, Becsey AN, Sanghadia CP, Root KT, Lucke-Wold B. Spine Bracing: When to Utilize-A Narrative Review. Biomechanics (Basel) 2023; 3:136-154. [PMID: 36949902 PMCID: PMC10029751 DOI: 10.3390/biomechanics3010013] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Spinal bracing is a common non-surgical technique that allows clinicians to prevent and correct malformations or injuries of a patient's spinal column. This review will explore the current standards of practice on spinal brace utilization. Specifically, it will highlight bracing usage in traumatic injuries, pregnancy, pediatrics, osteoporosis, and hyperkyphosis; address radiological findings concurrent with brace usage; and provide an overview of the braces currently available and advancements in the field. In doing so, we aim to improve clinicians' understanding and knowledge of bracing in common spinal pathologies to promote their appropriate use and improve patient outcomes.
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Affiliation(s)
- John L. Cerillo
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, FL 33759, USA
| | | | - Chai P. Sanghadia
- Department of Molecular and Cellular Biology, University of Arizona, Tucson, AZ 85721, USA
| | - Kevin T. Root
- College of Medicine, University of Florida, Gainesville, FL 32608, USA
| | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, Gainesville, FL 32608, USA
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Diaz MJ, Fadil A, Tran JT, Batchu S, Root KT, Tran AX, Lucke-Wold B. Primary and Metastatic Cutaneous Melanomas Discriminately Enrich Several Ligand-Receptor Interactions. Life (Basel) 2023; 13:life13010180. [PMID: 36676129 PMCID: PMC9865490 DOI: 10.3390/life13010180] [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] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/30/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Cutaneous melanoma remains a leading cancer with sobering post-metastasis mortality rates. To date, the ligand-receptor interactome of melanomas remains weakly studied despite applicability to anti-cancer drug discovery. Here we leverage established crosstalk methodologies to characterize important ligand-receptor pairs in primary and metastatic cutaneous melanoma. METHODS Bulk transcriptomic data, representing 470 cutaneous melanoma samples, was retrieved from the Broad Genome Data Analysis Center Firehose portal. Tumor and stroma compartments were computationally derived as a function of tumor purity estimates. Identification of preferential ligand-receptor interactions was achieved by relative crosstalk scoring of 1380 previously established pairs. RESULTS Metastatic cutaneous melanoma uniquely enriched PTH2-PTH1R for tumor-to-stroma signaling. The Human R-spondin ligand family was involved in 4 of the 15 top-scoring stroma-to-tumor interactions. Receptor ACVR2B was involved in 3 of the 15 top-scoring tumor-to-tumor interactions. CONCLUSIONS Numerous gene-level differences in ligand-receptor crosstalk between primary and metastatic cutaneous melanomas. Further investigation of notable pairings is warranted.
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Affiliation(s)
- Michael J. Diaz
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
- Correspondence:
| | - Angela Fadil
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Jasmine T. Tran
- School of Medicine, University of Indiana, Indianapolis, IN 46202, USA
| | - Sai Batchu
- Cooper Medical School, Rowan University, Camden, NJ 08103, USA
| | - Kevin T. Root
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Andrew X. Tran
- Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, Gainesville, FL 32611, USA
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Penev YP, Beneke A, Root KT, Meisel E, Kwak S, Diaz MJ, Root JL, Hosseini MR, Lucke-Wold B. Therapeutic Effectiveness of Brain Computer Interfaces in Stroke Patients: A Systematic Review. J Exp Neurol 2023; 4:87-93. [PMID: 37799298 PMCID: PMC10552326 DOI: 10.33696/neurol.4.077] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Background Brain-computer interfaces (BCIs) are a rapidly advancing field which utilizes brain activity to control external devices for a myriad of functions, including the restoration of motor function. Clinically, BCIs have been especially impactful in patients who suffer from stroke-mediated damage. However, due to the rapid advancement in the field, there is a lack of accepted standards of practice. Therefore, the aim of this systematic review is to summarize the current literature published regarding the efficacy of BCI-based rehabilitation of motor dysfunction in stroke patients. Methodology This systematic review was performed in accordance with the guidelines set forth by the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) 2020 statement. PubMed, Embase, and Cochrane Library were queried for relevant articles and screened for inclusion criteria by two authors. All discrepancies were resolved by discussion among both reviewers and subsequent consensus. Results 11/12 (91.6%) of studies focused on upper extremity outcomes and reported larger initial improvements for participants in the treatment arm (using BCI) as compared to those in the control arm (no BCI). 2/2 studies focused on lower extremity outcomes reported improvements for the treatment arm compared to the control arm. Discussion/Conclusion This systematic review illustrates the utility BCI has for the restoration of upper extremity and lower extremity motor function in stroke patients and supports further investigation of BCI for other clinical indications.
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Affiliation(s)
- Yordan P. Penev
- ICollege of Medicine, University of Florida, Gainesville, Florida, USA
| | - Alice Beneke
- ICollege of Medicine, University of Florida, Gainesville, Florida, USA
| | - Kevin T. Root
- ICollege of Medicine, University of Florida, Gainesville, Florida, USA
| | - Emily Meisel
- ICollege of Medicine, University of Florida, Gainesville, Florida, USA
| | - Sean Kwak
- ICollege of Medicine, University of Florida, Gainesville, Florida, USA
| | - Michael J. Diaz
- ICollege of Medicine, University of Florida, Gainesville, Florida, USA
| | | | | | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
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Root KT, Wright JO, Mandato N, Stewart BD, Moser MW. Subacromial-Subdeltoid Bursitis With Rice Bodies After Rotator Cuff Repair With a Collagen Scaffold Implant: A Case Report. JBJS Case Connect 2023; 13:01709767-202303000-00025. [PMID: 36735809 DOI: 10.2106/jbjs.cc.22.00565] [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: 08/27/2022] [Accepted: 11/30/2022] [Indexed: 02/05/2023]
Abstract
CASE We report the second-known case of subacromial-subdeltoid bursitis with rice bodies after rotator cuff repair with a Smith + Nephew REGENETEN bovine-derived bioinductive collagen scaffold implant. After the removal of rice bodies and a portion of implant that had not incorporated, the patient recovered well and made a full return to work and recreational activities. CONCLUSION This case demonstrates that persistent pain, swelling, or decreased range of motion for several months after rotator cuff repair with the use of a collagen implant may warrant a relatively early magnetic resonance imaging to evaluate for underlying pathology. It also provides a framework for physicians who may see similar patients in the future.
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Affiliation(s)
- Kevin T Root
- College of Medicine, University of Florida, Gainesville, Florida
| | - Jonathan O Wright
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida
| | | | - Brian D Stewart
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, Florida
| | - Michael W Moser
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida
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Lucke-Wold B, Cerillo JL, Becsey AN, Chernicki BP, Root KT. Minimally Invasive Procedures, Perioperative Telemedicine, and Decreased Hospital Stays Following Covid-19 Surgical Restrictions: Spinal Surgery. Arch Med Case Rep Case Study 2022; 6:153. [PMID: 36844926 PMCID: PMC9956112] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The 2019 severe acute respiratory syndrome coronavirus 2 pandemic had devastating impacts on healthcare system operations. Disruption of this delicate system led to international healthcare challenges with new policy changes that affected all specialties, including the global spine surgery community. The pandemic disrupted normal spine surgery proceedings, restricting, and postponing elective procedures, which comprise a large proportion of spine surgeries. This disruption may have contributed to significant economic losses for providers and resulted in the prolonged impairment of patients who were forced to postpone their procedures. However, response to the pandemic precipitated new procedural guidelines and practices that prioritize health outcomes and satisfaction. These new changes and innovations are positioned to provide lasting economic and procedural impacts in favor of both providers and patients. Thus, the objective of our review is to explore how spinal surgical practices and post-op recovery changed following COVID-19 and highlight some lasting impacts the pandemic created for future patients.
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Affiliation(s)
| | - John L Cerillo
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, FL, USA
| | | | - Brendan P Chernicki
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, FL, USA
| | - Kevin T Root
- College of Medicine, University of Florida, Gainesville, Florida, USA
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Diaz MJ, Fadil A, Kleinberg G, Root KT, Ladehoff L, Batchu S, Lucke-Wold B. Omics analysis of uveal melanoma: Leukocyte gene signatures reveal novel survival distinctions and indicate a prognostic role for cytolytic activity scoring. Neurosci Chron 2022; 3:6-11. [PMID: 36866123 PMCID: PMC9977264] [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] [Grants] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
Objective The significant metastatic potential of uveal melanoma (UVM) lends to high mortality. Even with successful local tumor treatment, many patients will develop metastatic disease. The present study aims to elucidate the relationship between tumor-infiltrating immune cell (TIIC) diversity and survival to identify potential therapeutic targets and improve UVM prognosis. Methods Bulk deconvolution was used to determine the relative proportions of 22 hematopoietic TIIC from 80 UVM tumor samples. Cytolytic activity (CYT) was determined, and associated survival probabilities were mined using time-to-event data. Nominal P-values were subjected to FDR correction. Results High relative abundance of tumor-infiltrating naïve B cells, resting memory CD4+ T cells, and monocytes correlated with better overall and disease-free survival probability. Low relative abundance of CD8+ T cells correlated with better overall survival and disease-free survival probability. CYT correlated positively with relative abundance of naïve B cells, resting memory CD4+ T cells, and monocytes. CYT correlated negatively with relative abundance of CD8+ T cells. Conclusion Infiltrating naïve B cells, resting memory CD4+ T cells, monocytes, and CD8+ T cells are potential therapeutic targets in UVM that warrant further investigation. High CYT estimates associate with worse UVM survival outcomes.
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Affiliation(s)
| | - Angela Fadil
- University of Florida, College of Medicine, Gainesville, FL, USA
| | - Giona Kleinberg
- Northeastern University, College of Engineering, Boston, MA, USA
| | - Kevin T Root
- University of Florida, College of Medicine, Gainesville, FL, USA
| | - Lauren Ladehoff
- University of South Florida, Morsani College of Medicine, USA
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