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Lamarche N, Tapon N, Stowers L, Burbelo PD, Aspenström P, Bridges T, Chant J, Hall A. Rac and Cdc42 induce actin polymerization and G1 cell cycle progression independently of p65PAK and the JNK/SAPK MAP kinase cascade. Cell 1996; 87:519-29. [PMID: 8898204 DOI: 10.1016/s0092-8674(00)81371-9] [Citation(s) in RCA: 501] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Rac and Cdc42 regulate a variety of responses in mammalian cells including formation of lamellipodia and filopodia, activation of the JNK MAP kinase cascade, and induction of G1 cell cycle progression. Rac is also one of the downstream targets required for Ras-induced malignant transformation. Rac and Cdc42 containing a Y40C effector site substitution no longer intact with the Ser/Thr kinase p65PAK and are unable to activate the JNK MAP kinase pathway. However, they still induce cytoskeletal changes and G1 cell cycle progression. Rac containing an F37A effector site substitution, on the other hand, no longer interacts with the Ser/Thr kinase p160ROCK and is unable to induce lamellipodia or G1 progression. We conclude that Rac and Cdc42 control MAP kinase pathways and actin cytoskeleton organization independently through distinct downstream targets.
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501 |
2
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Peacock JA, Cole S, Norberg P, Baugh CM, Bland-Hawthorn J, Bridges T, Cannon RD, Colless M, Collins C, Couch W, Dalton G, Deeley K, De Propris R, Driver SP, Efstathiou G, Ellis RS, Frenk CS, Glazebrook K, Jackson C, Lahav O, Lewis I, Lumsden S, Maddox S, Percival WJ, Peterson BA, Price I, Sutherland W, Taylor K. A measurement of the cosmological mass density from clustering in the 2dF Galaxy Redshift Survey. Nature 2001; 410:169-73. [PMID: 11242069 DOI: 10.1038/35065528] [Citation(s) in RCA: 500] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The large-scale structure in the distribution of galaxies is thought to arise from the gravitational instability of small fluctuations in the initial density field of the Universe. A key test of this hypothesis is that forming superclusters of galaxies should generate a systematic infall of other galaxies. This would be evident in the pattern of recessional velocities, causing an anisotropy in the inferred spatial clustering of galaxies. Here we report a precise measurement of this clustering, using the redshifts of more than 141,000 galaxies from the two-degree-field (2dF) galaxy redshift survey. We determine the parameter beta = Omega0.6/b = 0.43 +/- 0.07, where Omega is the total mass-density parameter of the Universe and b is a measure of the 'bias' of the luminous galaxies in the survey. (Bias is the difference between the clustering of visible galaxies and of the total mass, most of which is dark.) Combined with the anisotropy of the cosmic microwave background, our results favour a low-density Universe with Omega approximately 0.3.
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24 |
500 |
3
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Puls A, Eliopoulos AG, Nobes CD, Bridges T, Young LS, Hall A. Activation of the small GTPase Cdc42 by the inflammatory cytokines TNF(alpha) and IL-1, and by the Epstein-Barr virus transforming protein LMP1. J Cell Sci 1999; 112 ( Pt 17):2983-92. [PMID: 10444392 DOI: 10.1242/jcs.112.17.2983] [Citation(s) in RCA: 114] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Cdc42, a Rho-family GTPase, has been implicated in several signal transduction pathways, including organization of the actin cytoskeleton, activation of the c-Jun N-terminal MAP kinase (JNK) and stimulation of the nuclear transcription factor kappa B (NF(kappa)B). We report here that exposure of fibroblasts to the inflammatory cytokines tumor necrosis factor (alpha) (TNF(alpha)) and interleukin-1 (IL-1) triggers the activation of Cdc42 leading first to filopodia formation and subsequently to Rac and Rho activation. Inhibition of Cdc42 completely suppresses cytokine-induced actin polymerization, but not activation of JNK or NF(kappa)B. The latent membrane protein 1 of Epstein-Barr virus, LMP1, is thought to mimic constitutively activated TNF family receptors. When expressed in fibroblasts, LMP1 stimulates Cdc42-dependent filopodia formation as well as JNK and NF(kappa)B activation. Using LMP1 mutants, we show that activation of Cdc42 and JNK/NF(kappa)B occur through distinct pathways and that Cdc42 activation is independent of LMP1's interaction with TRADD and TRAF proteins.
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Bridges T, King G, Mohammed A. The effect of age on tooth movement and mineral density in the alveolar tissues of the rat. Am J Orthod Dentofacial Orthop 1988; 93:245-50. [PMID: 3422781 DOI: 10.1016/s0889-5406(88)80010-6] [Citation(s) in RCA: 94] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A comparison of tooth movement cycles and changes in alveolar tissue mineral densities was made between young (21 to 28 days old) and adult (90 to 100 days old) rats. An initial 60-g mesial tipping force was applied to the maxillary first molars; tooth movement was estimated by measuring the opening between first and second molars, and tissue mineral density by sample ash weight per cubic centimeter. A characteristic three-part tooth movement cycle was found in both groups of rats. This cycle consists of an early "instantaneous" movement that is a function of the viscoelastic properties of the tissues, a delay period during which little tooth movement occurs due to hyalinization and undermining resorption, and a late period during which bone remodeling and tooth movement occur. Compared with the adult group, the amount of "instantaneous" movement in the young rats was greater (P less than 0.001), the delay period was shorter, and the rate of late tooth movement was faster (P less than 0.001). The young rats had significantly lower (P less than 0.05) mineral densities before orthodontic treatment. Both groups experienced a slight but insignificant increase in density followed by rapid declines to a nadir that was not different between the groups. The young rats reached this point by day 5 and the adults by day 7. The point of lowest mineral density occurred in the treated alveolar tissues toward the end of the delay period for each group and was followed by a return to control values at rates that were not significantly different between the groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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Comparative Study |
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Linkov I, Satterstrom FK, Kiker G, Batchelor C, Bridges T, Ferguson E. From comparative risk assessment to multi-criteria decision analysis and adaptive management: recent developments and applications. ENVIRONMENT INTERNATIONAL 2006; 32:1072-93. [PMID: 16905190 DOI: 10.1016/j.envint.2006.06.013] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Environmental risk assessment and decision-making strategies over the last several decades have become increasingly more sophisticated, information-intensive, and complex, including such approaches as expert judgment, cost-benefit analysis, and toxicological risk assessment. One tool that has been used to support environmental decision-making is comparative risk assessment (CRA), but CRA lacks a structured method for arriving at an optimal project alternative. Multi-criteria decision analysis (MCDA) provides better-supported techniques for the comparison of project alternatives based on decision matrices, and it also provides structured methods for the incorporation of project stakeholders' opinions in the ranking of alternatives. We argue that the inherent uncertainty in our ability to predict ecosystem evolution and response to different management policies requires shifting from optimization-based management to an adaptive management paradigm. This paper brings together a multidisciplinary review of existing decision-making approaches at regulatory agencies in the United States and Europe and synthesizes state-of-the-art research in CRA, MCDA, and adaptive management methods applicable to environmental remediation and restoration projects. We propose a basic decision analytic framework that couples MCDA with adaptive management and its public participation and stakeholder value elicitation methods, and we demonstrate application of the framework to a realistic case study based on contaminated sediment management issues in the New York/New Jersey Harbor.
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Comparative Study |
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Andersen DC, Bridges T, Gawlitzek M, Hoy C. Multiple cell culture factors can affect the glycosylation of Asn-184 in CHO-produced tissue-type plasminogen activator. Biotechnol Bioeng 2000; 70:25-31. [PMID: 10940860 DOI: 10.1002/1097-0290(20001005)70:1<25::aid-bit4>3.0.co;2-q] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Human tissue-type plasminogen activator (t-PA) contains a variably occupied glycosylation site at Asn-184 in naturally produced t-PA and in t-PA produced in recombinant Chinese hamster ovary (CHO) cells. The presence of an oligosaccharide at this site has previously been shown to reduce specific activity and fibrin binding. In this report, the site occupancy of t-PA is shown to increase gradually over the course of batch and fed-batch CHO cultures. Additional cell culture factors, including butyrate and temperature, are also shown to influence the degree of glycosylation. In each of these cases, conditions with decreased growth rate correlate with increased site occupancy. Investigations using quinidine and thymidine to manipulate the cell cycle distribution of cultures further support this correlation between site occupancy and growth state. Comparison of the cell cycle distribution across the range of cell culture factors investigated shows a consistent relationship between site occupancy and the fraction of cells in the G(0)/G(1) phase of the cell cycle. These results support a correlation between growth state and site occupancy, which fundamentally differs from site occupancy trends previously observed and illustrates the importance of the growth profile of CHO cultures in producing consistently glycosylated recombinant glycoproteins.
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Taylor RB, Brown CG, Bridges T, Werman HA, Ashton J, Hamlin RL. A model for regional blood flow measurements during cardiopulmonary resuscitation in a swine model. Resuscitation 1988; 16:107-18. [PMID: 2839880 DOI: 10.1016/0300-9572(88)90075-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Recent reports examining regional blood flow during cardiopulmonary resuscitation (CPR) have been criticized for several reasons: (1) cardiac arrest times of 5 min or less are not reflective of the prehospital setting, (2) anesthetic agents may significantly influence autonomic control of regional blood flow, (3) canine cardiac anatomy and coronary blood supply are not reflective of humans and (4) precise validation data for blood flow measurements have not been reported. This study presents a methodology and model for measuring regional blood flow during CPR after a prolonged cardiac arrest. Fifteen swine weighing 15-25.4 kg were instrumented for regional blood flow measurements using tracer microspheres. Regional cerebral and myocardial blood flow were measured during normal sinus rhythm (NSR) and during CPR following a 10-min cardiopulmonary arrest. Regional blood flow (ml/min/100 g) to the cerebral cortices averaged less than 3% of baseline flow (NSR: right cortex = 41.2 +/- 13.8; left cortex = 41.2 +/- 12.2; CPR: right cortex = 1.3 +/- 1.2; left cortex = 1.3 +/- 1.3). Total myocardial blood flow averaged less than 5% of baseline flow (NSR = 211.5 +/- 104.9; CPR = 9.5 +/- 14.9). The flow data demonstrates minimal cardiac and cerebral perfusion with standard CPR following a 10-min arrest. The variability in the pilot data may be used in determining sample sizes for future studies.
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Rebollar EA, Bridges T, Hughey MC, Medina D, Belden LK, Harris RN. Integrating the role of antifungal bacteria into skin symbiotic communities of three Neotropical frog species. ISME JOURNAL 2019; 13:1763-1775. [PMID: 30867545 DOI: 10.1038/s41396-019-0388-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 02/16/2019] [Accepted: 02/28/2019] [Indexed: 01/10/2023]
Abstract
Chytridiomycosis, caused by the pathogen Batrachochytrium dendrobatidis (Bd), has led to population declines and extinctions of frog species around the world. While it is known that symbiotic skin bacteria can play a protective role against pathogens, it is not known how these defensive bacteria are integrated into the bacterial community on amphibian skin. In this study, we used 16S rRNA gene amplicon sequencing, culturing and Bd inhibition bioassays to characterize the communities of skin bacteria on three Neotropical frog species that persist in a Bd-infected area in Panama and determined the abundance and integration of anti-Bd bacteria into the community. We found that the two treefrog species had a similar bacterial community structure, which differed from the more diverse community found on the terrestrial frog. Co-occurrence networks also revealed differences between frog species such that the treefrogs had a significantly higher number of culturable Bd-inhibitory OTUs with high centrality scores compared with the terrestrial frog. We found that culture-dependent OTUs captured between 21 and 39% of the total relative abundance revealed in culture-independent communities. Our results suggest different ecological strategies occurring within skin antifungal communities on host species that have not succumbed to Bd infections in the wild.
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Research Support, U.S. Gov't, Non-P.H.S. |
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Linkov I, Satterstrom FK, Kiker G, Seager TP, Bridges T, Gardner KH, Rogers SH, Belluck DA, Meyer A. Multicriteria decision analysis: a comprehensive decision approach for management of contaminated sediments. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2006; 26:61-78. [PMID: 16492181 DOI: 10.1111/j.1539-6924.2006.00713.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Contaminated sediments and other sites present a difficult challenge for environmental decisionmakers. They are typically slow to recover or attenuate naturally, may involve multiple regulatory agencies and stakeholder groups, and engender multiple toxicological and ecotoxicological risks. While environmental decision-making strategies over the last several decades have evolved into increasingly more sophisticated, information-intensive, and complex approaches, there remains considerable dissatisfaction among business, industry, and the public with existing management strategies. Consequently, contaminated sediments and materials are the subject of intense technology development, such as beneficial reuse or in situ treatment. However, current decision analysis approaches, such as comparative risk assessment, benefit-cost analysis, and life cycle assessment, do not offer a comprehensive approach for incorporating the varied types of information and multiple stakeholder and public views that must typically be brought to bear when new technologies are under consideration. Alternatively, multicriteria decision analysis (MCDA) offers a scientifically sound decision framework for management of contaminated materials or sites where stakeholder participation is of crucial concern and criteria such as economics, environmental impacts, safety, and risk cannot be easily condensed into simple monetary expressions. This article brings together a multidisciplinary review of existing decision-making approaches at regulatory agencies in the United States and Europe and synthesizes state-of-the-art research in MCDA methods applicable to the assessment of contaminated sediment management technologies. Additionally, it tests an MCDA approach for coupling expert judgment and stakeholder values in a hypothetical contaminated sediments management case study wherein MCDA is used as a tool for testing stakeholder responses to and improving expert assessment of innovative contaminated sediments technologies.
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Karlin D, Jakobiec F, Harrison W, Bridges T, Patel CK, Strnad AR, Wood O. Endophotocoagulation in vitrectomy with a carbon dioxide laser. Am J Ophthalmol 1986; 101:445-50. [PMID: 3083683 DOI: 10.1016/0002-9394(86)90645-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A continuous-wave carbon dioxide laser operating at a wavelength of 10.6 microns has been applied transvitreally by means of a miniature articulating arm and intraocular probe to produce chorioretinal lesions in albino white rabbit eyes. The advantages of using a carbon dioxide laser are its lack of pigment dependence, its ability to act both as a photocoagulator and as a phototransector, and its ability to deposit its energy in a well-defined area without adverse effect on neighboring ocular tissue. The main disadvantage of the carbon dioxide laser in vitreoretinal surgery is that in a fluid medium, such as the vitreous, the laser tip must be placed in direct physical contact with the target tissue to obtain a reaction.
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39 |
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Elgarøy Ø, Lahav O, Percival WJ, Peacock JA, Madgwick DS, Bridle SL, Baugh CM, Baldry IK, Bland-Hawthorn J, Bridges T, Cannon R, Cole S, Colless M, Collins C, Couch W, Dalton G, De Propris R, Driver SP, Efstathiou GP, Ellis RS, Frenk CS, Glazebrook K, Jackson C, Lewis I, Lumsden S, Maddox S, Norberg P, Peterson BA, Sutherland W, Taylor K. New upper limit on the total neutrino mass from the 2 degree field galaxy redshift survey. PHYSICAL REVIEW LETTERS 2002; 89:061301. [PMID: 12190573 DOI: 10.1103/physrevlett.89.061301] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2002] [Indexed: 05/23/2023]
Abstract
We constrain f(nu) identical with Omega(nu)/Omega(m), the fractional contribution of neutrinos to the total mass density in the Universe, by comparing the power spectrum of fluctuations derived from the 2 Degree Field Galaxy Redshift Survey with power spectra for models with four components: baryons, cold dark matter, massive neutrinos, and a cosmological constant. Adding constraints from independent cosmological probes we find f(nu)<0.13 (at 95% confidence) for a prior of 0.1<Omega(m)<0.5, and assuming the scalar spectral index n=1. This translates to an upper limit on the total neutrino mass m(nu,tot)<1.8 eV for "concordance" values of Omega(m) and the Hubble constant.
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23 |
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13
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Johnston M, Bridges T, Palen B, Parsons E, Wemple M, Adamson R. Hands-on Pulmonary Curriculum: Interactive Learning Sessions on Oxygen Delivery, Spirometry, Positive Airway Pressure Devices, Tracheostomy, and Thoracostomy Tubes. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2017; 13:10633. [PMID: 30800834 PMCID: PMC6338185 DOI: 10.15766/mep_2374-8265.10633] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 08/21/2017] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Pulmonary equipment has become ubiquitous in clinical care. Basic device troubleshooting and mechanical manipulation skills are crucial to the practicing physician yet are frequently neglected in standard pulmonary curricula. METHODS We developed a hands-on pulmonary curriculum for medical residents and students, focusing on oxygen delivery, spirometry, positive airway pressure devices, thoracostomy, and tracheostomy knowledge. The curriculum, consisting of five 1-hour sessions, offers hands-on experience with basic pulmonary equipment relevant to the ICU and/or pulmonary clinic. Each session is led by a pulmonologist or critical care facilitator and designed for a learning audience of 10-15 internal medicine trainees and medical students. More than 11 sessions have been conducted since curriculum implementation. RESULTS Voluntary, immediate, pre- and postsession surveys assessed objective subject knowledge, perceived subject understanding, and perceived effectiveness of this hands-on format versus a conventional lecture style. A total of 52 learners returned surveys. Aggregate responses demonstrated that these sessions were typically the first formal training learners had received in these subject areas. Subject knowledge and perceived level of subject understanding both improved, and respondents reported the hands-on style of teaching was more effective than conventional lecture format. DISCUSSION Focused on practical knowledge, this pulmonary hands-on curriculum addresses a knowledge gap for medical trainees, has been enthusiastically received by trainees, and provides a useful resource for faculty wishing to teach about these devices.
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research-article |
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Bridges T, Meade M, Brush P, Lee Y, Narayanan R, McCurdy MA, Lambrechts M, Charlton A, Jenkins E, Juniewicz R, Destine H, Kaye ID, Kurd M, Canseco J, Hilibrand A, Vaccaro AR, Schroeder G, Kepler C. Early Diet Liberalization After Anterior Lumbar Interbody Fusion Improves Postoperative Recovery. Global Spine J 2025; 15:1087-1093. [PMID: 38149647 PMCID: PMC11877583 DOI: 10.1177/21925682231223461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2023] Open
Abstract
STUDY DESIGN Retrospective Cohort Study. OBJECTIVES The objective of this study was to assess the impact of diet liberalization on short-term outcomes in patients undergoing anterior interbody lumbar fusion (ALIF). METHODS A retrospective review was performed for patients undergoing ALIF at our tertiary care center institution from 2010 to 2022. Electronic medical records were reviewed for demographics, surgical characteristics, and 90-day postoperative outcomes. RESULTS We included 515 patients in this study with 102 patients receiving a full diet on the same day as their operation. All other patients had a delay of at least 1 day (average 1.6 days) until a full diet was provided. This group was found to have a higher rate of postoperative ileus (10.2% vs 2.9%) and urinary retention (16.0% vs 3.9%). The readmission rate and percent of patients presenting to the emergency department within 90 days postoperatively were similar. On multivariate regression analysis, same-day, full-diet patients had decreased odds of developing urinary retention (OR = .17) and a shorter length of hospital stay (Estimate: -.99). Immediate full diet had no impact on the development of ileus (OR: .33). CONCLUSIONS An immediate postoperative full diet following an anterior approach to the lumbar spine was not found to be associated with an increased risk of postoperative ileus in patients deemed appropriate for early diet liberalization. Moreover, an early full diet was found to reduce length of hospitalization and risk of postoperative urinary retention. Reconsideration of postoperative diet protocols may help optimize patient outcomes and recovery.
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Lanier B, Antonova E, Ortiz B, Trzaskoma B, Paknis B, Iqbal A, Bridges T. P147 Omalizumab reduces healthcare resource use in children. Ann Allergy Asthma Immunol 2016. [DOI: 10.1016/j.anai.2016.09.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Rubinstein A, Bridges T, McNeil D, Tachdjian R, Wedner H, Wasserman R, Leibl H, Rabbat C, Honigberg R, Yel L. P279 Post-authorization safety study of hyaluronidase-facilitated subcutaneous immunoglobulin 10% treatment in patients with primary immunodeficiency diseases. Ann Allergy Asthma Immunol 2017. [DOI: 10.1016/j.anai.2017.08.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Meade MH, Narayanan R, Buchan L, Bridges T, Opara OA, Brush PL, Lee Y, Glover A, Takagi-Stewart J, Ducaji E, Kurd MF, Canseco JA, Hilibrand AS, Vaccaro AR, Schroeder GD, Kepler CK. Physical and Psychological Impact of Scar Cosmesis After Cervical Spine Fusion Surgery. World Neurosurg 2024; 189:e1077-e1082. [PMID: 39032633 DOI: 10.1016/j.wneu.2024.07.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 07/09/2024] [Accepted: 07/10/2024] [Indexed: 07/23/2024]
Abstract
INTRODUCTION Patients' and surgeons' perceptions of cutaneous scarring can vary, causing unpleasant physical and psychological outcomes. This study aims to bridge the current scientific literature gap and understand the impact of patient-perceived scar cosmesis after anterior and posterior cervical spine surgery. METHODS Retrospective review of patients ≥18 years old who underwent anterior or posterior cervical spine surgery from 2017 to 2022 at a large, urban academic group. To select patients with adequate time for surgical scar maturation, only patients who were greater than 6 months postsurgery were included. The Scar Questionaire Survey (SCAR-Q) survey, a surgical scar assessment tool, was administered to patients to assess patient perceptions of scar symptomatology, appearance, and psychosocial impact. Scores range from 0 to 100, with 100 as the best outcome. An additional 5-item Likert scale question was administered to assess overall surgical satisfaction. RESULTS All 854 respondents who completed the survey were stratified into 2 groups "Unsatisfied vs. Satisfied." Patients who were "unsatisfied" with their surgery had the lowest outcome scores for SCAR-Q appearance, symptom, and psychosocial scores than those who were "Satisfied" (P < 0.001). Females had significantly "higher/more favorable" responses for SCAR-Q Appearance (77.5 vs. 82.8 P < 0.001) and Psychosocial (87.4 vs. 94.3 P < 0.001) scores compared to males. Regression analysis performed for each component score showed that increases in all 3 component scores were significant in patients in the satisfied group. CONCLUSIONS Our study demonstrates that cervical spine surgery patients unsatisfied with their surgical outcome have lower scar-related scores, highlighting the impact of cosmetic closure and appearance.
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Costanzo J, McCahon J, Tokarski AT, Deirmengian C, Bridges T, Fliegel BE, Deirmengian GK. Mechanical Complications of Hip and Knee Spacers Are Common. Cureus 2023; 15:e38496. [PMID: 37273394 PMCID: PMC10238283 DOI: 10.7759/cureus.38496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 06/06/2023] Open
Abstract
Introduction Two-stage revision is frequently used for the treatment of periprosthetic joint infection (PJI). Because antibiotic-loaded cement spacers are constructed and implanted as temporary devices, mechanical complications are possible. The purpose of our study was to define the incidence of such mechanical complications, determine associated risk factors, and establish if such complications influence the subsequent success of PJI treatment. Methods We identified patients who received an antibiotic spacer for the treatment of PJI at a single center over a six-year timeframe. Medical records and all radiographs were collected and reviewed. Radiographic changes over time were recorded, and mechanical complications were noted. We used multivariate logistic regression analysis to assess risk factors for mechanical spacer complications and assess whether such complications influence the likelihood of subsequent reimplantation and ultimate component retention. Results A total of 236 patients were included in the study. There were 82 hip spacers (28% dynamic and 72% static) with a mechanical complication rate of 8.5% and 154 knee spacers (44% dynamic and 56% static) with a mechanical complication rate of 18.2%. Knee spacers were significantly more likely to have mechanical complications than hip spacers. Other risk factors for mechanical complications included bone loss and elevated body mass index (BMI). Bone loss and advanced age were found to be independent risk factors for failure to undergo second-stage reimplantation. Mechanical spacer failure was not an independent risk factor for the likelihood of subsequent reimplantation or ultimate component retention. Conclusions Mechanical complications of antibiotic spacers are common but do not appear to negatively impact the likelihood of subsequent reimplantation or component retention. In knee spacers and in patients with bone loss or elevated BMI, appropriate patient counseling and strategies to prevent such complications are recommended.
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