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Kelly MJ, Gelfand B, Radcliff K, Mo FF, Felix BA, Babak Kalantar S. Interim 1-Year Radiographic and Clinical Outcomes Following Anterior Cervical Discectomy and Fusion Using Hydroxyapatite-Infused Polyetheretherketone Interbody Cages. Int J Spine Surg 2024:8585. [PMID: 38378231 DOI: 10.14444/8585] [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: 02/22/2024] Open
Abstract
BACKGROUND This is a multicenter observational registry analysis of 1-year radiographic and clinical outcomes following anterior cervical discectomy and fusion (ACDF) using hydroxyapatite (HA)-infused polyetheretherketone (PEEK) intervertebral cages. METHODS Radiographic and clinical outcome data were collected preoperatively and at 6 weeks, 3 months, 6 months, and 12 months postoperatively. To assess fusion, dynamic flexion-extension radiographs were independently evaluated with a validated method. Clinical outcomes were assessed using the following disease-specific measures: Neck Disability Index (NDI) and visual analog scale (VAS) for neck, left arm, and right arm pain. Patient satisfaction was also evaluated. RESULTS A total of 789 ACDF patients (men: 51.5%/women: 48.5%; mean body mass index: 29.9 kg/m2) were included at the time of analysis, and 1565 segments have been operated. Successful fusion was confirmed in 91.3% of all operated levels after 6 months and 92.2% after 12 months. Mean NDI scores improved significantly (P < 0.01) preoperatively (46.3, n = 771) to postoperatively (12 months: 25.2, n = 281). Consistently, mean VAS neck (preoperative: 64.2, n = 770; 12 months: 28.6, n = 278), VAS right arm (preoperative: 42.6, n = 766; 12 months: 20.4, n = 277), and VAS left arm (preoperative: 41.1, n = 768; 12 months: 20.8, n = 277) decreased significantly (P < 0.01). Patients reported high satisfaction rates after surgery with no significant changes in postoperative patient satisfaction between 6 weeks and 12 months (95.1%, n = 273). CONCLUSIONS ACDF with HA-infused PEEK cages demonstrates promising radiographic and clinical outcomes, supporting the potential benefits of incorporating HA into PEEK cages to enhance fusion rates and improve patient outcomes. CLINICAL RELEVANCE This study demonstrates a >90% fusion rate by level with reliable improvements in patient reported outcomes, along with a high rate of patient satisfaction, in a large patient cohort undergoing ACDF with HA-infused PEEK cages. LEVEL OF EVIDENCE 2 .
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Affiliation(s)
| | | | | | - Fred F Mo
- MedStar Georgetown University Hospital, Washington, DC, USA
| | - Brox A Felix
- Princeton University, Undergraduate Student, Princeton, NJ, USA
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Hamzeh M, Gwynne K, Panish BJ, Gelfand B, Argintar E. Measuring Parallelism to the Ground in Bipedal Stance Phase: Mechanical Versus Kinematic Alignment in Total Knee Arthroplasty. Cureus 2024; 16:e55173. [PMID: 38558684 PMCID: PMC10980562 DOI: 10.7759/cureus.55173] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction The goal of total knee arthroplasty is to replace diseased cartilage and bone with an artificial implant to improve the patient's quality of life. The knee has historically been reconstructed to the patient's mechanical axis (MA). However, kinematically aligned techniques have been increasingly used. Kinematic alignment requires less soft-tissue resection and aligns the knee with what is anatomically natural to the patient, while there is concern that kinematically aligned knees will lead to earlier failure due to potential unequal weight distribution on the implant. The purpose of this study is to compare the parallelism from the floor of the joint-line cuts using kinematic and mechanical alignment and understand if the MA is a proper estimation of the tibial-ankle axis (TA). Methods A retrospective study was conducted by recruiting all high tibial osteotomy and distal femoral osteotomy recipients operated on by two surgeons in two MedStar Health hospitals from 01/2013 to 07/2020 with full-length films in preparation for restorative procedures. Baseline osteoarthritis was graded using the Kellgren-Lawrence classification system with all patients presenting as Grade 0. The TA and the joint-line orientations of the MA and kinematic axis (KA) were measured on 66 legs. The average distance from parallelism to the ground was compared between the MA and the KA and between the MA and the TA using a paired t-test. Results KA joint-line orientation (1.705° deviation) was more parallel to the floor in the bipedal stance phase than the MA (2.316° deviation, p=0.0156). The MA (2.316° deviation) was not a proper estimation of the TA (4.278° deviation, p=0.0001). Conclusion By utilizing the KA technique, the restoration of the natural joint line, as well as a joint that is more parallel to the floor in the stance phase compared to the MA, is achieved. The parallelism to the ground of the KA during the bipedal stance phase suggests an even load distribution across the knee. In addition, due to its similarity to the KA and anatomical significance in weight-bearing distribution, further investigation into the hip-to-calcaneal axis as an approximation of the joint line is warranted.
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Affiliation(s)
- Malaak Hamzeh
- Orthopaedic Surgery, Georgetown University School of Medicine, Washington, DC, USA
| | - Kaelyn Gwynne
- Orthopaedic Surgery, Georgetown University School of Medicine, Washington, DC, USA
| | - Brian J Panish
- Orthopaedic Surgery, Georgetown University School of Medicine, Washington, DC, USA
| | - Bradley Gelfand
- Orthopaedic Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Evan Argintar
- Orthopaedic Surgery, MedStar Washington Hospital Center, Washington, DC, USA
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Ropp A, Frazier AA, Gelfand B, Jeudy J. The Dean Effect: An Aortic Arch Flow Artifact Mimicking Dissection. Radiol Cardiothorac Imaging 2022; 4:e210229. [PMID: 35782762 PMCID: PMC8893211 DOI: 10.1148/ryct.210229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 11/13/2021] [Accepted: 11/29/2021] [Indexed: 06/15/2023]
Abstract
The unique hemodynamics of the aortic arch create conditions for potential formation of a flow-related artifact that mimics disease on CT angiographic images. The hemodynamic basis for this artifact can be explained by fluid mechanics incorporating a mathematical principle known as the Dean number. Therefore, in this review, the artifact is referred to as the Dean effect. It is important for radiologists and other clinicians to recognize this artifact when encountered. It is also helpful for the interpreting radiologist to have a basic understanding of the relevant hemodynamic principles. This review provides an example of the artifact, reviews the basic underlying hemodynamics, and presents methods of how to prevent this artifact and distinguish it from pathologic mimics in clinical practice. Keywords: CT Angiography, Vascular, Thorax, Aorta, Artifacts, Blood, Dissection, Hemodynamics/Flow Dynamics © RSNA, 2022.
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Shen H, Li J, Heisler-Taylor T, Makin R, Yang H, Mavlyutov TA, Gelfand B, Cebulla CM, Guo LW. TMEM97 ablation aggravates oxidant-induced retinal degeneration. Cell Signal 2021; 86:110078. [PMID: 34245862 PMCID: PMC8869839 DOI: 10.1016/j.cellsig.2021.110078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/01/2021] [Accepted: 07/05/2021] [Indexed: 10/20/2022]
Abstract
The retinal pigment epithelium (RPE) is critical to the survival of the overlying photoreceptors. Subject to light exposure and active metabolism, the RPE and photoreceptors are particularly susceptible to oxidative damage that plays an important part in age-related macular degeneration (AMD). Recent meta-analyses identified TMEM97 as a new putative AMD risk locus, though it is yet to be functionally verified. The role of TMEM97 in the retina and RPE is not known. Here we investigated TMEM97 function using the sodium iodate model of oxidant-induced retinal degeneration in TMEM97 knockout (KO) mice. We found markedly increased reactive oxygen species (ROS) and loss of photoreceptos in TMEM97 KO mouse retinas relative to wild type (WT) controls. In vitro, sodium iodate treatment of CRISPR-mediated TMEM97 KO RPE cells resulted in diminished abundance of the master antioxidant transcription factor NRF2 and its target gene product SOD2, the mitochondrial superoxide dismutase, as well as elevated ROS and apoptosis markers. Moreover, TMEM97 KO affected proteins key to mitochondrial and lysosomal stability and impeded autophagy flux. These findings suggest that the absence of TMEM97 in RPE cells disturbs redox-balancing systems, thereby heightening oxidative stress. As TMEM97 is a druggable target, this study may inspire interest in basic and translational research in the context of retinal degeneration.
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Affiliation(s)
- Hongtao Shen
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, VA 22908, USA
| | - Jing Li
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, VA 22908, USA
| | - Tyler Heisler-Taylor
- Department of Ophthalmology and Visual Sciences, The Ohio State University, Columbus, OH 43212, USA
| | - Ryan Makin
- Center for Advanced Vision Science, School of Medicine, University of Virginia, Charlottesville, VA 22908, USA; Department of Ophthalmology, School of Medicine, University of Virginia, Charlottesville, VA 22908, USA
| | - Huan Yang
- Department of Surgery, University of Wisconsin, Madison, WI 53705, USA
| | - Timur A Mavlyutov
- Department of Surgery, University of Wisconsin, Madison, WI 53705, USA
| | - Bradley Gelfand
- Center for Advanced Vision Science, School of Medicine, University of Virginia, Charlottesville, VA 22908, USA; Department of Ophthalmology, School of Medicine, University of Virginia, Charlottesville, VA 22908, USA; Department of Biomedical Engineering, School of Medicine, University of Virginia, Charlottesville, VA 22908, USA
| | - Colleen M Cebulla
- Department of Ophthalmology and Visual Sciences, The Ohio State University, Columbus, OH 43212, USA.
| | - Lian-Wang Guo
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, VA 22908, USA; Department of Ophthalmology, School of Medicine, University of Virginia, Charlottesville, VA 22908, USA.
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Tebo C, Mazer-Amirshahi M, DeGeorge L, Gelfand B, Leak C, Tolliver S, Sauter D. Suspected synthetic cannabinoid receptor agonist intoxication: Does analysis of samples reflect the presence of suspected agents? Am J Emerg Med 2019; 37:1846-1849. [DOI: 10.1016/j.ajem.2018.12.044] [Citation(s) in RCA: 5] [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] [Received: 11/15/2018] [Revised: 12/20/2018] [Accepted: 12/23/2018] [Indexed: 12/31/2022] Open
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Yaroshetskiy A, Protsenko D, Larin E, Ignatenko O, Gelfand B. End-expiratory esophageal pressure versus lower inflection point in acute lung injury. Crit Care 2013. [PMCID: PMC3642458 DOI: 10.1186/cc12041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Affiliation(s)
- D Protsenko
- Russian National Research Medical University, Moscow, Russia
| | - R Magomedov
- Russian National Research Medical University, Moscow, Russia
| | - O Ignatenko
- Russian National Research Medical University, Moscow, Russia
| | - AI Yaroshetskiy
- Russian National Research Medical University, Moscow, Russia
| | - B Gelfand
- Russian National Research Medical University, Moscow, Russia
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Ignatenko O, Protsenko D, Yaroshetskiy A, Gelfand B. Conventional mechanical ventilation can injury intact lungs in severe trauma patients. Crit Care 2010. [PMCID: PMC2934364 DOI: 10.1186/cc8432] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Yaroustovsky M, Gelfand B, Popok Z, Abramyan M, Nazarova E, Yakovleva I, Popov D, Plyushch M. Lipopolysaccharide adsorption in combined therapy of patients with severe sepsis. Crit Care 2008. [PMCID: PMC4088826 DOI: 10.1186/cc6676] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Yaroshetskiy A, Protsenko D, Yakovlev S, Gelfand B. Crit Care 2005; 9:P21. [DOI: 10.1186/cc3084] [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: 11/10/2022] Open
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Gelfand B, Popov T, Karabak V, Belocerkovsky B. Crit Care 2005; 9:P16. [DOI: 10.1186/cc3079] [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: 11/10/2022] Open
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Abstract
The WISC-RIQ scores of 85 children between 7 and 12 years of age taken from the inpatient, outpatient and day care facilities of a Regional Treatment Centre were compared with the expected IQ scores of the standard normal population. In addition, analysis of variance techniques were used to test for an association between IQ variables and seven operationally defined symptom subtypes taken from the child's chart. Significant differences between the clinical sample and the standard normal population were found for the distribution and means for full scale IQ and verbal IQ but not performance IQ. In addition, significant associations were found between FSIQ and the level of aggressive symptoms, and between VIQ and the level of hyperkinetic and aggressive symptom subtypes. The importance of IQ variables and in particular VIQ in understanding the nature of childhood psychiatric disorder is emphasized. The implications of these findings for educational policy are discussed.
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Gelfand B. The work evaluation setting as a student learning laboratory. Rehabil Lit 1972; 33:40-3. [PMID: 5061232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Gelfand B. Work evaluation tests as psychometric indices in low income clients. Arch Phys Med Rehabil 1970; 51:55-60. [PMID: 5412926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Gelfand B. The talk-work theory as it operates through group discussion in the work evaluation setting. Am J Occup Ther 1967; 21:146-50. [PMID: 6045378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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Gelfand B. The concept of reality as used in work evaluation and work adjustment. J Rehabil 1966; 32:26-8. [PMID: 4227238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Gelfand B. Some work types met in work evaluation. Rehabil Lit 1965; 26:335-8. [PMID: 5841683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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