1
|
Finlay JB, Issa K, Ackall F, Zomorodi A, Codd P, Jang DW, Goldstein BJ, Abi Hachem R. Safety and Feasibility of Steroid-Eluting Stent as a Bolster in Endoscopic Anterior Skull Base Reconstruction. Ann Otol Rhinol Laryngol 2024; 133:43-49. [PMID: 37334915 DOI: 10.1177/00034894231181178] [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: 06/21/2023]
Abstract
BACKGROUND With a rising incidence of cerebrospinal fluid (CSF) leaks, endoscopic endonasal CSF leak repair is increasingly performed. Current approaches utilize a variety of materials including free mucosal grafts and vascularized flaps, but post-op leaks continue to be reported. Steroid-eluting bioabsorbable stents (SES) are used during functional endoscopic sinus surgery for chronic rhinosinusitis to reduce inflammation and scarring while maintaining patency of sinus ostia. OBJECTIVE The aim of this study is to assess the feasibility of SES as a graft/flap bolster for endoscopic endonasal CSF leak repair. METHODS This is a retrospective review of patients undergoing endoscopic endonasal CSF leak repair with SES placed as part of the bolster technique at a tertiary care center between January 2019 and May 2022. Age, sex, BMI, comorbid idiopathic intracranial hypertension, pathology, location of CSF leak, intraoperative CSF leak flow, reconstruction type, and presence of post-op CSF leak were recorded. RESULTS Twelve patients (mean age 52, median BMI 30.9, 58% female) had SES placement as part of the bolster technique. The most common pathology was meningoencephalocele (75%). Reconstruction was performed with either a free mucosal graft (6), or a flap (6). No post-op CSF leaks occurred at a reconstruction site with a stent, and no known complications were reported. All sinusotomies were patent at the last follow-up visit. CONCLUSIONS SES placement as an adjunct to graft and/or flap bolster appears to be safe and feasible during anterior skull base reconstruction and CSF leak repair providing longer term structural support and preserving sinus drainage patency.
Collapse
Affiliation(s)
- John B Finlay
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, USA
- Medical Scientist Training Program, Duke University School of Medicine, Durham, NC, USA
| | - Khalil Issa
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Feras Ackall
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Ali Zomorodi
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA
- Duke Skull Base Center, Duke University School of Medicine, Durham, NC, USA
| | - Patrick Codd
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA
- Duke Skull Base Center, Duke University School of Medicine, Durham, NC, USA
| | - David W Jang
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, USA
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA
- Duke Skull Base Center, Duke University School of Medicine, Durham, NC, USA
| | - Bradley J Goldstein
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, USA
- Department of Neurobiology, Duke University School of Medicine, Durham, NC, USA
| | - Ralph Abi Hachem
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, USA
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA
- Duke Skull Base Center, Duke University School of Medicine, Durham, NC, USA
| |
Collapse
|
2
|
Abdulaziz F, Issa K, Alyami M, Alotibi S, Alanazi AA, Taha TAM, Saad AME, Hammouda GA, Hamad N, Alshaaer M. Preparation and Characterization of Mono- and Biphasic Ca 1-xAg xHPO 4·nH 2O Compounds for Biomedical Applications. Biomimetics (Basel) 2023; 8:547. [PMID: 37999188 PMCID: PMC10669227 DOI: 10.3390/biomimetics8070547] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/09/2023] [Accepted: 11/12/2023] [Indexed: 11/25/2023] Open
Abstract
This study aimed to explore the effects of the full-scale replacement (up to 100%) of Ca2+ ions with Ag1+ ions in the structure of brushite (CaHPO4·2H2O). This substitution has potential benefits for producing monophasic and biphasic Ca1-xAgxHPO4·nH2O compounds. To prepare the starting solutions, (NH4)2HPO4, Ca(NO3)2·4H2O, and AgNO3 at different concentrations were used. The results showed that when the Ag/Ca molar ratio was below 0.25, partial substitution of Ca with Ag reduced the size of the unit cell of brushite. As the Ag/Ca molar ratio increased to 4, a compound with both monoclinic CaHPO4·2H2O and cubic nanostructured Ag3PO4 phases formed. There was a nearly linear relationship between the Ag ion ratio in the starting solutions and the wt% precipitation of the Ag3PO4 phase in the resulting compound. Moreover, when the Ag/Ca molar ratio exceeded 4, a single-phase Ag3PO4 compound formed. Hence, adjusting the Ag/Ca ratio in the starting solution allows the production of biomaterials with customized properties. In summary, this study introduces a novel synthesis method for the mono- and biphasic Ca1-xAgxHPO4·nH2O compounds brushite and silver phosphate. The preparation of these phases in a one-pot synthesis with controlled phase composition resulted in the enhancement of existing bone cement formulations by allowing better mixing of the starting ingredients.
Collapse
Affiliation(s)
- Fahad Abdulaziz
- Department of Chemistry, College of Science, University of Ha’il, Ha’il 81451, Saudi Arabia;
| | - Khalil Issa
- Orthopedics Unit, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus 00972, Palestine;
| | - Mohammed Alyami
- Department of Physics, College of Science and Humanities in Al-Kharj, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (M.A.); (S.A.); (A.M.E.S.); (N.H.)
| | - Satam Alotibi
- Department of Physics, College of Science and Humanities in Al-Kharj, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (M.A.); (S.A.); (A.M.E.S.); (N.H.)
| | - Abdulaziz A. Alanazi
- Department of Chemistry, College of Science and Humanities in Al-Kharj, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (A.A.A.); (G.A.H.)
| | - Taha Abdel Mohaymen Taha
- Physics Department, College of Science, Jouf University, P.O. Box 2014, Sakaka 72388, Saudi Arabia;
- Physics and Engineering Mathematics Department, Faculty of Electronic Engineering, Menoufia University, Menouf 32952, Egypt
| | - Asma M. E. Saad
- Department of Physics, College of Science and Humanities in Al-Kharj, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (M.A.); (S.A.); (A.M.E.S.); (N.H.)
| | - Gehan A. Hammouda
- Department of Chemistry, College of Science and Humanities in Al-Kharj, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (A.A.A.); (G.A.H.)
| | - Nagat Hamad
- Department of Physics, College of Science and Humanities in Al-Kharj, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (M.A.); (S.A.); (A.M.E.S.); (N.H.)
| | - Mazen Alshaaer
- Department of Physics, College of Science and Humanities in Al-Kharj, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (M.A.); (S.A.); (A.M.E.S.); (N.H.)
- Department Mechanics of Materials and Constructions (MEMC), Vrije Universiteit Brussels (VUB), Pleinlaan 2, 1050 Brussels, Belgium
| |
Collapse
|
3
|
Ko T, Choi R, Issa K, Gupta R, Llinas E, Morey L, Finlay JB, Goldstein BJ. Polycomb repressive complex 2 regulates basal cell fate during adult olfactory neurogenesis. Stem Cell Reports 2023; 18:2283-2296. [PMID: 37832538 PMCID: PMC10679661 DOI: 10.1016/j.stemcr.2023.09.008] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 10/15/2023] Open
Abstract
Adult neurogenesis occurs in the mammalian olfactory epithelium to maintain populations of neurons that are vulnerable to injury yet essential for olfaction. Multipotent olfactory basal stem cells are activated by damage, although mechanisms regulating lineage decisions are not understood. Using mouse lesion models, we focused on defining the role of Polycomb repressive complexes (PRCs) in olfactory neurogenesis. PRC2 has a well-established role in developing tissues, orchestrating transcriptional programs via chromatin modification. PRC2 proteins are expressed in olfactory globose basal cells (GBCs) and nascent neurons. Conditional PRC2 loss perturbs lesion-induced neuron production, accompanied by altered histone modifications and misexpression of lineage-specific transcription factors in GBCs. De-repression of Sox9 in PRC2-mutant GBCs is accompanied by increased Bowman's gland production, defining an unrecognized role for PRC2 in regulating gland versus neuron cell fate. Our findings support a model for PRC2-dependent mechanisms promoting sensory neuronal differentiation in an adult neurogenic niche.
Collapse
Affiliation(s)
- Tiffany Ko
- Department of Neurobiology, Duke University School of Medicine, Durham, NC 27710, USA
| | - Rhea Choi
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC 27710, USA
| | - Khalil Issa
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC 27710, USA
| | - Rupali Gupta
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC 27710, USA
| | - Edward Llinas
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC 27710, USA
| | - Lluis Morey
- Sylvester Comprehensive Cancer Center and Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - John B Finlay
- Medical Scientist Training Program, Duke University School of Medicine, Durham, NC 27710, USA
| | - Bradley J Goldstein
- Department of Neurobiology, Duke University School of Medicine, Durham, NC 27710, USA; Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC 27710, USA.
| |
Collapse
|
4
|
Issa K, Teitelbaum J, Smith BD, Wang F, Ackall F, Sargi Z, Rangarajan SV, Jung SH, Jang DW, Abi Hachem R. Nasal Cavity Squamous Cell Carcinoma: Factors Associated With Treatment Outcomes and Potential Organ Preservation. Am J Rhinol Allergy 2022; 37:35-42. [DOI: 10.1177/19458924221130133] [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] [Indexed: 11/17/2022]
Abstract
Background Squamous cell carcinoma of the nasal cavity (NCSCC) is a rare, challenging malignancy. Surgical resection of this tumor can cause significant facial deformity, and indications for adjuvant or organ preservation therapies are not well-described. Objective To examine the impact of treatment regimen on survival outcomes in NCSCC and to compare surgical to non-surgical based therapies. Methods The National Cancer Database was queried for NCSCC from 2004 to 2014. Patient demographics, tumor characteristics, and treatment regimen were compared for the entire cohort. Multivariable Cox proportional hazards regression was performed for statistical analysis of treatment regimen and surgical margins on overall survival (OS) for early and late-stage disease. Results A total of 1883 NCSCC patients were identified. The OS for the cohort was 83 months, and median age at diagnosis was 65 years. NCSCC patients who underwent surgery followed by adjuvant radiation therapy (RT) had a better OS compared to definitive RT (HR: 0.58, P < .001). In early stage NCSCC (T1/T2, N0), there was no significant difference in OS between patients treated with surgery only or surgery with adjuvant RT compared to definitive RT. In advanced stage NCSCC, surgery with adjuvant RT had a better OS compared to definitive chemoradiation. Having positive margins was shown to predict a worse OS when compared to negative margins in surgical patients despite adjuvant RT or chemoradiation. Conclusions NCSCC appears to be best treated with surgery followed by adjuvant RT in advanced-stage disease whereas in early-stage disease, surgery does not improve OS compared to definitive RT.
Collapse
Affiliation(s)
- Khalil Issa
- Department of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, North Carolina
| | - Jordan Teitelbaum
- Department of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, North Carolina
| | - Blaine D. Smith
- Department of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, North Carolina
| | - Frances Wang
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina
| | - Feras Ackall
- Department of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, North Carolina
| | - Zoukaa Sargi
- Department of Otolaryngology, University of Miami, Miami, Florida
| | - Sanjeet V. Rangarajan
- Department of Otolaryngology and Head and Neck Surgery, The University of Tennessee Health Sciences Center, Memphis, Tennessee
| | - Sin-Ho Jung
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina
| | - David W Jang
- Department of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, North Carolina
| | - Ralph Abi Hachem
- Department of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, North Carolina
| |
Collapse
|
5
|
Huang RJ, Teitelbaum JI, Issa K, Truong T, Kim H, Kuchibhatla M, Hachem RA, Goldstein BJ, Jang DW. Endoscopic Sinus Surgery in Older Patients With Significant Medical Comorbidities. Am J Rhinol Allergy 2022; 36:661-667. [PMID: 35578407 DOI: 10.1177/19458924221101438] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 01/11/2023]
Abstract
BACKGROUND Endoscopic sinus surgery (ESS) offers excellent outcomes for patients with chronic rhinosinusitis (CRS) in the general population. It is unclear whether older patients with significant medical comorbidities experience similar benefits. OBJECTIVE The purpose of this study is to evaluate whether increasing medical comorbidity is associated with worse sinonasal quality of life outcomes after ESS in older patients. METHODS This is a retrospective study of CRS patients 55 years or older who underwent elective ESS at an academic institution from July 2017 to June 2019. 22-Item Sino-Nasal Outcomes Test (SNOT-22) scores were gathered at baseline as well as at 3 and 6 months following surgery. Data on demographics, medical comorbidities, preoperative Lund-Mackay (LM) scores, and postoperative complications were extracted from the medical record. The Charlson Comorbidity Index (CCI) was calculated for each patient. Multivariate linear regression was used to evaluate a potential association between CCI and change in SNOT-22 scores at 3 months postoperatively. RESULTS A total of 205 patients met inclusion criteria with a mean (SD) CCI score of 2 (2.4) and a CCI score range of 0 to 11. The mean (SD) LM score was 8 (5.3). Rates of asthma and nasal polyposis were 28.3% and 36.6%, respectively. The mean (SD) improvement in SNOT-22 scores at 3 and 6 months compared to baseline was 17.9 (19.7) and 20.9 (18.1) points, respectively. After adjusting for covariates, there was no significant association between CCI and change in SNOT-22 scores. CONCLUSION Greater medical comorbidity is not associated with worse SNOT-22 outcomes postoperatively, although future studies are needed to determine if comorbidities are associated with higher complication rates. A multidisciplinary approach to perioperative care is critical in maintaining the safety and efficacy of ESS in this patient population.
Collapse
Affiliation(s)
- Ryan J Huang
- Division of Rhinology & Endoscopic Skull Base Surgery, Department of Head and Neck Surgery & Communication Sciences, 22957Duke University Health System, Durham, NC
| | - Jordan I Teitelbaum
- Division of Rhinology & Endoscopic Skull Base Surgery, Department of Head and Neck Surgery & Communication Sciences, 22957Duke University Health System, Durham, NC
| | - Khalil Issa
- Division of Rhinology & Endoscopic Skull Base Surgery, Department of Head and Neck Surgery & Communication Sciences, 22957Duke University Health System, Durham, NC
| | - Tracy Truong
- Department of Biostatistics and Bioinformatics, 22957Duke University, Durham, NC
| | - Heewon Kim
- Department of Biostatistics and Bioinformatics, 22957Duke University, Durham, NC
| | | | - Ralph Abi Hachem
- Division of Rhinology & Endoscopic Skull Base Surgery, Department of Head and Neck Surgery & Communication Sciences, 22957Duke University Health System, Durham, NC
| | - Bradley J Goldstein
- Division of Rhinology & Endoscopic Skull Base Surgery, Department of Head and Neck Surgery & Communication Sciences, 22957Duke University Health System, Durham, NC
| | - David W Jang
- Division of Rhinology & Endoscopic Skull Base Surgery, Department of Head and Neck Surgery & Communication Sciences, 22957Duke University Health System, Durham, NC
| |
Collapse
|
6
|
Oliva AD, Gupta R, Issa K, Abi Hachem R, Jang DW, Wellford SA, Moseman EA, Matsunami H, Goldstein BJ. Aging-related olfactory loss is associated with olfactory stem cell transcriptional alterations in humans. J Clin Invest 2022; 132:155506. [PMID: 34990409 PMCID: PMC8843745 DOI: 10.1172/jci155506] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 01/04/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUNDPresbyosmia, or aging-related olfactory loss, occurs in a majority of humans over age 65 years, yet remains poorly understood, with no specific treatment options. The olfactory epithelium (OE) is the peripheral organ for olfaction and is subject to acquired damage, suggesting a likely site of pathology in aging. Adult stem cells reconstitute the neuroepithelium in response to cell loss under normal conditions. In aged OE, patches of respiratory-like metaplasia have been observed histologically, consistent with a failure in normal neuroepithelial homeostasis.MethodsAccordingly, we have focused on identifying cellular and molecular changes in presbyosmic OE. The study combined psychophysical testing with olfactory mucosa biopsy analysis, single-cell RNA-Sequencing (scRNA-Seq), and culture studies.ResultsWe identified evidence for inflammation-associated changes in the OE stem cells of presbyosmic patients. The presbyosmic basal stem cells exhibited increased expression of genes involved in response to cytokines or stress or the regulation of proliferation and differentiation. Using a culture model, we found that cytokine exposure drove increased TP63, a transcription factor acting to prevent OE stem cell differentiation.ConclusionsOur data suggest aging-related inflammatory changes in OE stem cells may contribute to presbyosmia via the disruption of normal epithelial homeostasis. OE stem cells may represent a therapeutic target for restoration of olfaction.FundingNIH grants DC018371, NS121067, DC016224; Office of Physician-Scientist Development, Burroughs-Wellcome Fund Research Fellowship for Medical Students Award, Duke University School of Medicine.
Collapse
Affiliation(s)
- Allison D. Oliva
- Department of Head and Neck Surgery & Communication Sciences and
| | - Rupali Gupta
- Department of Head and Neck Surgery & Communication Sciences and
| | - Khalil Issa
- Department of Head and Neck Surgery & Communication Sciences and
| | - Ralph Abi Hachem
- Department of Head and Neck Surgery & Communication Sciences and
| | - David W. Jang
- Department of Head and Neck Surgery & Communication Sciences and
| | | | | | - Hiroaki Matsunami
- Department of Molecular Genetics and Microbiology,,Duke Institute for Brain Sciences,,Department of Neurobiology, and
| | - Bradley J. Goldstein
- Department of Head and Neck Surgery & Communication Sciences and,Department of Neurobiology, and,Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, North Carolina, USA
| |
Collapse
|
7
|
Ji KSY, Frank-Ito D, Abi Hachem R, Issa K, Johnson C, Mohamedaly O, Goldstein BJ, Jang DW. Endoscopic Sinus Surgery for Cystic Fibrosis: Variables Influencing Sinonasal and Pulmonary Outcomes. Am J Rhinol Allergy 2021; 36:307-312. [PMID: 34806427 DOI: 10.1177/19458924211059606] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Endoscopic sinus surgery is a well-established treatment for chronic rhinosinusitis in patients with cystic fibrosis, though its benefits seem to be limited to improving sinonasal symptoms rather than affecting lung function. OBJECTIVE This study aims to identify clinical and demographic factors that may influence sinonasal and pulmonary outcomes after surgery. METHODS This is a six-year retrospective analysis of adult cystic fibrosis patients who underwent endoscopic sinus surgery at a tertiary care center. 22-Item Sino-Nasal Outcomes Test scores and mean forced expiratory volume data at baseline and three to six months after surgery were analyzed using t-test and stepwise regression with the following covariates: age, gender, lung transplant, revision surgery, and pseudomonas on sinus culture. RESULTS 119 surgeries were performed on 88 patients, with 69% on patients with transplant. The overall mean (Standard Deviation) improvement in 22-Item Sino-Nasal Outcomes Test score was 9.42 (18.15) for the entire cohort (P < .001). Pseudomonas on culture was associated with less improvement in sinonasal scores (P = .002). There was no significant change in forced expiratory volume after surgery (P = .94). Revision surgery (P = .004) and older age (P = .007) were associated with less favorable change of pulmonary function on stepwise regression (P = .002). There was no correlation between change in sinonasal scores and pulmonary function. CONCLUSION Although surgery was associated with a clinically and statistically significant improvement in sinonasal scores in cystic fibrosis patients, patients with pseudomonas may experience less benefit. Revision surgery and older age may be associated with less favorable pulmonary outcomes. Awareness of such variables may help when deciding which cystic fibrosis patients should undergo surgery.
Collapse
Affiliation(s)
- Keven S Y Ji
- 12277Duke University School of Medicine, Durham, NC, USA.,6684Oregon Health & Science University Hospital, Portland, OR, USA
| | | | | | - Khalil Issa
- 22957Duke University Hospital, Durham, NC, USA
| | | | | | | | | |
Collapse
|
8
|
Fish T, Issa K, Levine CG, Jang DW, Chen PG. Assessment of Available Online Information About Nasopharyngeal Swab Testing in Patient Instructions for Sinus and Pituitary Surgery. JAMA Otolaryngol Head Neck Surg 2021; 147:572-573. [PMID: 33662126 DOI: 10.1001/jamaoto.2020.5663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Taylor Fish
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Health San Antonio, San Antonio
| | - Khalil Issa
- Division of Rhinology and Endoscopic Skull Base Surgery, Department of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, North Carolina
| | - Corinna G Levine
- Department of Otolaryngology-Head and Neck Surgery, Miller School of Medicine, University of Miami, Miami, Florida
| | - David W Jang
- Division of Rhinology and Endoscopic Skull Base Surgery, Department of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, North Carolina
| | - Philip G Chen
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Health San Antonio, San Antonio
| |
Collapse
|
9
|
Sfeir PM, Issa K, Ayoub CM. Mesenteric Malperfusion Syndromes in Type A Aortic Dissection: Current Management Strategies. J Cardiothorac Vasc Anesth 2021; 35:3711-3719. [PMID: 34217577 DOI: 10.1053/j.jvca.2021.05.056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/26/2021] [Accepted: 05/30/2021] [Indexed: 11/11/2022]
Abstract
Acute type A aortic dissection is a surgical emergency associated with high mortality and morbidity. When complicated with mesenteric malperfusion, its management carries a very high mortality. Many innovations in the field of vascular and cardiothoracic surgery in the last two decades have been tried in the continuous efforts to improve on the surgical outcomes. Although some reports have documented better mortality rates with reperfusion-first strategies, there is still room for improvement in the absence of a general consensus on its management.
Collapse
Affiliation(s)
- Pierre M Sfeir
- American University of Beirut Medical Center, Department of Surgery, Beirut, Lebanon
| | - Khalil Issa
- Duke University School of Medicine, Durham, NC
| | - Chakib M Ayoub
- Department of Anesthesiology, Duke University Medical Center, Durham, NC.
| |
Collapse
|
10
|
Issa K, Smith BD, Kaplan SJ, Madden J, Jang DW, Zomorodi A, Brizel D, Abi Hachem R. A systematic review on sinonasal mixed adenoneuroendocrine carcinoma. Int Forum Allergy Rhinol 2021; 11:1391-1394. [PMID: 34013656 DOI: 10.1002/alr.22811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/19/2021] [Accepted: 04/14/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Khalil Issa
- Department of Head and Neck Surgery & Communication Sciences, Duke University, Durham, NC
| | - Blaine D Smith
- Department of Head and Neck Surgery & Communication Sciences, Duke University, Durham, NC
| | - Samantha J Kaplan
- Duke Medical Center Library, Duke University School of Medicine, Durham, NC
| | - John Madden
- Department of Pathology/Division of Pathology Clinical Services, Duke University, Durham, NC
| | - David W Jang
- Department of Head and Neck Surgery & Communication Sciences, Duke University, Durham, NC
| | - Ali Zomorodi
- Department of Neurosurgery, Duke University, Durham, NC
| | - David Brizel
- Department of Radiation Oncology, Duke University, Durham, NC
| | - Ralph Abi Hachem
- Department of Head and Neck Surgery & Communication Sciences, Duke University, Durham, NC
| |
Collapse
|
11
|
Issa K, Abi Hachem R, Gordee A, Truong T, Pfohl R, Doublestein B, Lee W. Analysis of Self- and 360-Evaluation Scores of the Professionalism Intelligence Model Within an Academic Otolaryngology-Head and Neck Surgery Department. J Healthc Leadersh 2021; 13:129-136. [PMID: 34007234 PMCID: PMC8123941 DOI: 10.2147/jhl.s296501] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 04/21/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To analyze self and 360-evaluation scores of the professionalism intelligence model domains within an academic Otolaryngology-Head and Neck Surgery Department. Methods A leadership course was introduced within the Department of Head and Neck Surgery & Communication Sciences at Duke University Medical Center. A 360 evaluation assessing domains of the professional intelligence model was recorded for all participants. Participant demographics included gender (male vs female), generation group (generation Y vs older generations) and physician status of participants (physician vs non-physician). Differences in mean self-scores were modeled using linear regression. When analyzing the evaluator scores, gaps were defined as self-score minus evaluator-score for each member of a participant’s evaluator groupings (supervisor, peer, and direct report). Two types of linear mixed models were fit with a random intercept to account for the correlated gaps in the same participant. Results Scores of 50 participants and 394 evaluators were analyzed. The average age was 40.6 (standard deviation 9.3) years, and 50% (N=25) of participants were females. Physicians accounted for 36% (N=18) of the cohort, and 61% (N=11) of physicians were residents. Physicians scored themselves lower than non-physicians when assessing leadership intelligence, interpersonal relations, empathy, and focused thinking. On average, participants under-rated themselves compared to their evaluators with direct reports giving higher scores than managers and peers. When compared with generation Y, older generations tended to rate themselves lower than their peers and managers in cognitive intelligence. No significant association was observed between gender and any scores. Conclusion Participants rate themselves lower on average than their evaluators. This work is important in understanding how perceived leadership qualities are assessed and developed within an academic surgical department. Finally, the results presented could serve as a model to address the gap between self- and other-perceptions of defined leadership virtues in future leadership development activities.
Collapse
Affiliation(s)
- Khalil Issa
- Department of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, NC, USA
| | - Ralph Abi Hachem
- Department of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, NC, USA
| | - Alexander Gordee
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - Tracy Truong
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - Richard Pfohl
- School of Business, LeTourneau University, Longview, TX, USA
| | - Barry Doublestein
- School of Business & Leadership, Regent University, Virginia Beach, VA, USA
| | - Walter Lee
- Department of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, NC, USA
| |
Collapse
|
12
|
Issa K, Ackall F, Jung SH, Li J, Jang DW, Rangarajan SV, Abi Hachem R. Survival outcomes in sinonasal carcinoma with neuroendocrine differentiation: A NCDB analysis. Am J Otolaryngol 2021; 42:102851. [PMID: 33385873 DOI: 10.1016/j.amjoto.2020.102851] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/03/2020] [Accepted: 12/12/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Sinonasal carcinoma with neuroendocrine differentiation (SCND) is a rare group of tumors with poor prognosis. Treatment and sequence of therapies are still unclear. The goal of this study is to analyze treatment outcomes in SCND using a national database. METHODS The National Cancer Database was queried for SCND from 2004 to 2014. Patient demographics, tumor characteristics and treatment paradigms were tabulated. Multivariable Cox proportional hazards regression was performed for statistical analysis of treatment regimen on overall survival (OS). RESULTS A total of 415 patients were identified. Most patients were male (61.2%), with a median age of 58 years and the most common primary site was the nasal cavity (52.5%). T4 tumors were observed in 67.7% of cases. Unimodality (41.9%) and bimodality (43.9%) therapies were the most common treatment modalities. Radiation therapy was the only treatment administered in 30% of the patients, while 27.2% received definitive chemoradiation (CRT) and 11.6% had surgery with adjuvant CRT. In our Cox-PH model, age (HR = 1.04, p < 0.001), T4 (HR = 2.6, p = 0.004) and N2/N3 (HR = 2.18, p = 0.001) were associated with worse survival. Trimodality (HR = 0.49, p = 0.005) and bimodality (HR = 0.65, p = 0.009) therapies had a better OS compared to unimodality. Patients treated with definitive CRT or surgery with adjuvant CRT had a significant increase in OS (p = 0.01 and 0.002 respectively). CONCLUSION SCND appears to be best treated using a multimodality approach with definitive CRT or surgery followed by CRT. Neoadjuvant chemotherapy could be helpful in selecting the best treatment strategy.
Collapse
|
13
|
Issa K, Teitelbaum JI, Jang DW, Goldstein BJ, Chan L, Hachem RA. Sinus Irrigation Penetration After Proposed Modified Draf IIa Technique in a Side-to-Side Cadaveric Model. Am J Rhinol Allergy 2020; 35:487-493. [PMID: 33086859 DOI: 10.1177/1945892420969141] [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: 11/16/2022]
Abstract
BACKGROUND Endoscopic sinus surgery (ESS) is an effective intervention for patients with medically refractory chronic rhinosinusitis. Frontal sinusotomy is the most challenging part of ESS, with one of the key outcomes being access for topical irrigations. OBJECTIVE The purpose of this study is to compare irrigation penetration into the frontal sinus following Draf IIa versus modified Draf IIa frontal sinusotomy. METHODS Four fresh cadaver heads were used in this experiment. Draf IIa was performed on one side of each head and a modified Draf IIa on the contralateral side. This proposed modification consists of a Draf IIa combined with an agger nasi punch-out procedure and partial trimming of the vertical lamella of the middle turbinate back to the posterior table of the frontal sinus without drilling the beak. Each head was irrigated with methylene blue-dyed water and recorded by rigid endoscopy through an endonasal view (EV) of the frontal sinus and frontal trephination view (TV). Two blinded rhinologists scored the extent of staining (using an ordinal scale of 0 to 3) for each side. A case report where the modified Draf IIa was performed is also described. RESULTS After modified Draf IIa sinuosotomy, the mean score for the EV was 2.125 and for the TV was 2, versus 0.875 and 0.625 for traditional Draf IIa, respectively. There was a statistically significant increase for both EV (p = 0.019) and TV (p = 0.018) after modified Draf IIa. CONCLUSION In our cadaveric model, this procedural modification improved penetration of postoperative irrigations into the frontal sinus. This simple technique may be easily adapted into frontal ESS when indicated.
Collapse
Affiliation(s)
| | - Jordan I Teitelbaum
- Division of Rhinology & Endoscopic Skull Base Surgery, Department of Head and Neck Surgery & Communications Sciences, Duke University Medical Center, Durham, North Carolina
| | - David W Jang
- Division of Rhinology & Endoscopic Skull Base Surgery, Department of Head and Neck Surgery & Communications Sciences, Duke University Medical Center, Durham, North Carolina
| | - Bradley J Goldstein
- Division of Rhinology & Endoscopic Skull Base Surgery, Department of Head and Neck Surgery & Communications Sciences, Duke University Medical Center, Durham, North Carolina
| | - Lyndon Chan
- Division of Rhinology & Endoscopic Skull Base Surgery, Department of Head and Neck Surgery & Communications Sciences, Duke University Medical Center, Durham, North Carolina
| | - Ralph Abi Hachem
- Division of Rhinology & Endoscopic Skull Base Surgery, Department of Head and Neck Surgery & Communications Sciences, Duke University Medical Center, Durham, North Carolina
| |
Collapse
|
14
|
Issa K, Stevens MN, Sun Y, Thomas S, Collins A, Cohen J, Esclamado RM, Rocke DJ. A Retrospective Study of Lymph Node Yield in Lateral Neck Dissection for Papillary Thyroid Carcinoma. Ear Nose Throat J 2020; 101:456-462. [PMID: 33090902 DOI: 10.1177/0145561320967339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 11/16/2022] Open
Abstract
OBJECTIVE Lateral neck dissection (LND) is important in managing papillary thyroid carcinomas (PTCs). This study aimed to evaluate the relationship between lymph node yield (LNY) for LND and patient outcomes, specifically postoperative serum thyroglobulin levels (sTG) and radioiodine uptake on thyroid scan, and to estimate a threshold LNY to signify adequate LND. METHODS Patients diagnosed with PTC who underwent LND from 2006 to 2015 at a single institution were included. Linear regression with restricted cubic splines was used to characterize the association of LNY with outcomes. Outcomes were log-transformed to achieve a more symmetric distribution prior to regression. For nonlinear associations, a Monte Carlo Markov Chain procedure was used to estimate a threshold LNY associated with postoperative outcome. This threshold was then used to define high LNY versus low LNY in the subsequent analyses. RESULTS In total, 107 adult patients were included. There was a significant relationship between LNY and postoperative sTG level (P = .004), but not radioiodine uptake (P = .64). An LNY of 42.96 was identified, which was associated with the maximum change in sTG level. No association was found between LNY groups (LNY ≥ 43 vs < 43) and radioiodine uptake, risk of complication, or longer operative times (all P > .05). High LNY was associated with a decrease in log(sTG) (estimate = -1.855, P = .03), indicating that adequacy of LND is associated with an 84.4% decrease in sTG. CONCLUSION These results suggest an association between LNY and postoperative sTG level, with an estimated threshold of 43 nodes. This has implications for adequate therapeutic LND; additional work is needed to validate thresholds for clinical practice.
Collapse
Affiliation(s)
- Khalil Issa
- Department of Head and Neck Surgery & Communication Sciences, 12277Duke University Health System, Durham, NC, USA
| | - Madelyn N Stevens
- Department of Head and Neck Surgery & Communication Sciences, 12277Duke University Health System, Durham, NC, USA.,Department of Otolaryngology-Head and Neck Surgery, 12328Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yuhui Sun
- Department of Biostatistics and Bioinformatics, 12277Duke University, Durham, NC, USA
| | - Samantha Thomas
- Department of Biostatistics and Bioinformatics, 12277Duke University, Durham, NC, USA.,Duke Cancer Institute, 12277Duke University, Durham, NC USA
| | - Alissa Collins
- Department of Head and Neck Surgery & Communication Sciences, 12277Duke University Health System, Durham, NC, USA
| | - Jonathan Cohen
- Department of Head and Neck Surgery & Communication Sciences, 12277Duke University Health System, Durham, NC, USA
| | - Ramon M Esclamado
- Department of Head and Neck Surgery & Communication Sciences, 12277Duke University Health System, Durham, NC, USA
| | - Daniel J Rocke
- Department of Head and Neck Surgery & Communication Sciences, 12277Duke University Health System, Durham, NC, USA.,Duke Cancer Institute, 12277Duke University, Durham, NC USA
| |
Collapse
|
15
|
Ackall FY, Issa K, Barak I, Teitelbaum J, Jang DW, Jung SH, Goldstein B, Carrau R, Abi Hachem R. Survival Outcomes in Sinonasal Poorly Differentiated Squamous Cell Carcinoma. Laryngoscope 2020; 131:E1040-E1048. [PMID: 32959912 DOI: 10.1002/lary.29090] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 08/11/2020] [Accepted: 08/22/2020] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Sinonasal squamous cell carcinoma (SCC) is rare with no consensus on treatment regimen. Our goal is to analyze treatment outcomes in poorly differentiated SCC (PDSCC) using a large national database. STUDY DESIGN Retrospective database study. METHODS The National Cancer Database was queried for sinonasal invasive SCC, grade 3 (poorly differentiated) from 2004 to 2014. Patient demographics and tumor and treatment characteristics were tabulated. Kaplan-Meier (KM) analysis was performed to compare overall survival (OS) between histology subtype and primary site. Multivariable Cox proportional hazards regression was performed for statistical analysis of treatment regimen on OS. RESULTS A total of 1,074 patients were identified. The maxillary sinus was the most common site (45%). T4 tumors were observed in 50% of patients, with most patients treated at high-volume facilities (77%). In KM analysis, spindle cell SCC histological subtype, primary tumors of the maxillary sinus, and poorly differentiated grade had worse OS. In our Cox-PH model, higher T stage and age were associated with worse OS. Those treated at a high-volume facility and those who underwent surgical resection followed by adjuvant radiation had improved OS. Chemotherapy within the treatment regimen did not confer survival benefit except in surgical patients when positive margins were present, and surgery with adjuvant chemoradiation trended toward improved survival. CONCLUSIONS Sinonasal PDSCC appears to be best treated at high-volume centers with surgical resection followed by adjuvant radiation. Poorly differentiated grade has worse OS compared to more differentiated tumors. Chemotherapy along with adjuvant radiation may have a role in patients with positive surgical margins. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E1040-E1048, 2021.
Collapse
Affiliation(s)
- Feras Y Ackall
- Department of Head and Neck Surgery & Communication Sciences, Duke University, Durham, North Carolina, U.S.A
| | - Khalil Issa
- Department of Head and Neck Surgery & Communication Sciences, Duke University, Durham, North Carolina, U.S.A
| | - Ian Barak
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, U.S.A
| | - Jordan Teitelbaum
- Department of Head and Neck Surgery & Communication Sciences, Duke University, Durham, North Carolina, U.S.A
| | - David W Jang
- Department of Head and Neck Surgery & Communication Sciences, Duke University, Durham, North Carolina, U.S.A
| | - Sin-H Jung
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, U.S.A
| | - Bradley Goldstein
- Department of Head and Neck Surgery & Communication Sciences, Duke University, Durham, North Carolina, U.S.A
| | - Ricardo Carrau
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State University Medical Center, Columbus, Ohio, U.S.A
| | - Ralph Abi Hachem
- Department of Head and Neck Surgery & Communication Sciences, Duke University, Durham, North Carolina, U.S.A
| |
Collapse
|
16
|
Teitelbaum JI, Issa K, Barak IR, Ackall FY, Jung SH, Jang DW, Abi Hachem R. Sinonasal Squamous Cell Carcinoma Outcomes: Does Treatment at a High-Volume Center Confer Survival Benefit? Otolaryngol Head Neck Surg 2020; 163:986-991. [DOI: 10.1177/0194599820935395] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objective To determine whether treatment of sinonasal squamous cell carcinoma (SCC) at a high-volume facility affects survival. Study Design Retrospective database analysis. Setting National Cancer Database (2004-2014). Subjects and Methods The National Cancer Database was queried for sinonasal SCC from 2004 to 2014. Patient demographics, tumor characteristics and classification, resection margins, treatment regimen, and facility case-specific volume—averaged per year and grouped in tertiles as low (0%-33%), medium (34%-66%), and high (67%-100%)—were compared. Overall survival was compared with Cox proportional hazards regression analysis. Results A total of 3835 patients treated for sinonasal SCC between 2004 and 2014 were identified. Therapeutic options included surgery alone (18.6%), radiotherapy (RT) alone (29.1%), definitive chemoradiation (15.4%), surgery with adjuvant RT (22.8%), and combinations (14.1%) of the aforementioned treatments. Patients who underwent surgery with adjuvant RT had better overall survival (hazard ratio [HR], 0.74; P < .001; 95% CI, 0.63-0.86). As for treatment volume per facility, 7.4% of patients were treated at a low-volume center, 17.5% at a medium-volume center, and 75.1% at a high-volume center. Univariate analysis showed that treatment at a high-volume facility conferred a significantly better overall survival (HR, 0.77; P = .002). Multivariable Cox proportional hazards regression analysis, adjusting for age, sex, tumor classification, and treatment regimen, demonstrated that patients who underwent treatment at a high-volume facility (HR, 0.81; P < .001) had significantly improved survival. Conclusion This study shows a better overall survival for sinonasal SCC treated at high-volume centers. Further study may be needed to understand the effect of case volume on the paradigms of sinonasal SCC management.
Collapse
Affiliation(s)
- Jordan I. Teitelbaum
- Division of Rhinology and Skull Base Surgery, Department of Head and Neck Surgery and Communication Sciences, Duke University Health System, Durham, North Carolina, USA
| | - Khalil Issa
- Division of Rhinology and Skull Base Surgery, Department of Head and Neck Surgery and Communication Sciences, Duke University Health System, Durham, North Carolina, USA
| | - Ian R. Barak
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA
| | - Feras Y. Ackall
- Division of Rhinology and Skull Base Surgery, Department of Head and Neck Surgery and Communication Sciences, Duke University Health System, Durham, North Carolina, USA
| | - Sin-Ho Jung
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA
| | - David W. Jang
- Division of Rhinology and Skull Base Surgery, Department of Head and Neck Surgery and Communication Sciences, Duke University Health System, Durham, North Carolina, USA
| | - Ralph Abi Hachem
- Division of Rhinology and Skull Base Surgery, Department of Head and Neck Surgery and Communication Sciences, Duke University Health System, Durham, North Carolina, USA
| |
Collapse
|
17
|
Pierce TP, Issa K, Ermann D, Scillia AJ, Festa A, Emami A, McInerney VK. Corrigendum to "National Trends in Orthopaedic Surgery Resident Adult Case Logs" J Surg Educ. 2019 May - Jun;76(3):893-897. J Surg Educ 2019; 76:1703. [PMID: 31153881 DOI: 10.1016/j.jsurg.2019.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- T P Pierce
- Seton Hall University, School of Health and Medical Sciences, Department of Orthopaedics
| | - K Issa
- Seton Hall University, School of Health and Medical Sciences, Department of Orthopaedics
| | - D Ermann
- Seton Hall University, School of Health and Medical Sciences, Department of Orthopaedics
| | - A J Scillia
- Seton Hall University, School of Health and Medical Sciences, Department of Orthopaedics.
| | - A Festa
- Seton Hall University, School of Health and Medical Sciences, Department of Orthopaedics
| | - A Emami
- Seton Hall University, School of Health and Medical Sciences, Department of Orthopaedics
| | - V K McInerney
- Seton Hall University, School of Health and Medical Sciences, Department of Orthopaedics
| |
Collapse
|
18
|
Issa K, Issaoui N, Ghalla H, Yaghmour SJ, Mahros AM, Oujia B. Ab initiostudy of Ba+Arn(n= 1–4) clusters: spectroscopic constants and vibrational energy levels. Mol Phys 2015. [DOI: 10.1080/00268976.2015.1086836] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
|
19
|
Yahya W, Issa K, Falaye B, Oyewumi K. Nonrelativistic and relativistic bound state solutions of the molecular Tietz potential via the improved asymptotic iteration method. CAN J CHEM 2014. [DOI: 10.1139/cjc-2013-0479] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We have obtained the approximate analytical solutions of the relativistic and nonrelativistic molecular Tietz potential using the improved asymptotic iteration method. By approximating the centrifugal term through the Greene–Aldrich approximation scheme, we have obtained the energy eigenvalues and wave functions for all orbital quantum numbers [Formula: see text]. Where necessary, we made comparison with the result obtained previously in the literature. The relative closeness of the two results reveal the accuracy of the method presented in this study. We proceed further to obtain the rotational-vibrational energy spectrum for some diatomic molecules. These molecules are CO, HCl, H2, and LiH. We have also obtained the relativistic bound state solution of the Klein−Gordon equation with this potential. In the nonrelativistic limits, our result converges to that of the Schrödinger system.
Collapse
Affiliation(s)
- W.A. Yahya
- Theoretical Physics Section, Department of Physics, University of Ilorin, Nigeria
- Department of Physics and Material Science, Kwara State University, Malete, P.M.B 1530, Ilorin, Kwara State, Nigeria
| | - K. Issa
- Department of Statistics and Mathematical Sciences, Kwara State University, Malete, Nigeria
| | - B.J. Falaye
- Theoretical Physics Section, Department of Physics, University of Ilorin, Nigeria
| | - K.J. Oyewumi
- Theoretical Physics Section, Department of Physics, University of Ilorin, Nigeria
| |
Collapse
|
20
|
Abstract
Symptomatic hip osteonecrosis is a disabling condition with a poorly understood aetiology and pathogenesis. Numerous treatment options for hip osteonecrosis are described, which include non-operative management and joint preserving procedures, as well as total hip replacement (THR). Non-operative or joint preserving treatment may improve outcomes when an early diagnosis is made before the lesion has become too large or there is radiographic evidence of femoral head collapse. The presence of a crescent sign, femoral head flattening, and acetabular involvement indicate a more advanced-stage disease in which joint preserving options are less effective than THR. Since many patients present after disease progression, primary THR is often the only reliable treatment option available. Prior to the 1990s, outcomes of THR for osteonecrosis were poor. However, according to recent reports and systemic reviews, it is encouraging that with the introduction of newer ceramic and/or highly cross-linked polyethylene bearings as well as highly-porous fixation interfaces, THR appears to be a reliable option in the management of end-stage arthritis following hip osteonecrosis in this historically difficult to treat patient population. Cite this article: Bone Joint J 2013;95-B, Supple A:46–50.
Collapse
Affiliation(s)
- K. Issa
- Sinai Hospital of Baltimore, 2401
W Belvedere Ave Baltimore, Maryland 21215, USA
| | - R. Pivec
- Sinai Hospital of Baltimore, 2401
W Belvedere Ave Baltimore, Maryland 21215, USA
| | - B. H. Kapadia
- Sinai Hospital of Baltimore, 2401
W Belvedere Ave Baltimore, Maryland 21215, USA
| | - S. Banerjee
- Sinai Hospital of Baltimore, 2401
W Belvedere Ave Baltimore, Maryland 21215, USA
| | - M. A. Mont
- Sinai Hospital of Baltimore, 2401
W Belvedere Ave Baltimore, Maryland 21215, USA
| |
Collapse
|
21
|
Adeyemi A, Azeez A, Issa K, Fakunle O. P2-352 Youth HIV prevalence and sexual behaviour indicators: evidence from Nigeria. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976k.84] [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: 11/04/2022]
|
22
|
Katsimihas M, Bailey CS, Issa K, Fleming J, Rosas-Arellano P, Bailey SI, Gurr KR. Prospective clinical and radiographic results of CHARITÉ III artificial total disc arthroplasty at 2- to 7-year follow-up: a Canadian experience. Can J Surg 2010; 53:408-4145. [PMID: 21092434 PMCID: PMC2993028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2010] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Early and intermediate results have shown that the SB CHARITÉ III total disc arthroplasty (TDA) favourably compares to spinal fusion, but is associated with fewer complications and higher levels of satisfaction. We sought to prospectively report the clinical and radiographic results of the CHARITÉ III TDA after an average of 55 months follow-up. METHODS We conducted a prospective study of patients receiving the CHARITÉ TDA at either L4-5 or L5-S1 between April 2001 and November 2006. The primary indication for surgery was discogenic low-back pain confirmed by provocative discography. Assessment included pre- and postoperative (3, 6 and 12 mo and yearly thereafter) validated patient outcome measures and radiographic review. RESULTS Fifty-seven of the potential 64 (89%) patients were available for complete follow-up. Their mean age was 39 (range 21-59) years. A statistically significant improvement was demonstrated between all the mean pre- and postoperative intervals for the Oswestry Disability Index, visual analogue scale for back and leg pain, and Short Form-36 health survey (p < 0.001). The mean sagittal rotation was 6.5° (range 0.5°-22.4°), and the mean intervertebral translation was 1.1 mm (range 0-2.4 mm). Subsidence of the implant was present in 44 of 53 (83%) patients with an L5-S1 disc arthroplasty. The mean subsidence was 1.7 mm (range 0-4.8 mm). CONCLUSION The 2- to 7-year follow-up of this cohort of patients demonstrated satisfactory clinical and radiographic results in a carefully selected patient population. The radiographic assessment confirmed preservation and maintenance of motion at the replaced disc during the period of follow-up.
Collapse
Affiliation(s)
| | - Christopher S. Bailey
- Correspondence to: Dr. C.S. Bailey, London Health Science Centre, Victoria Hospital, 800 Commissioners Rd. E, E4 120, London ON N6A 5W9,
| | | | | | | | | | | |
Collapse
|
23
|
Cobbold I, Lawrie G, Issa K. Designing a strategic management system using the third‐generation balanced scorecard. Int J Productivity & Perf Mgmt 2004. [DOI: 10.1108/17410400410561240] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
24
|
Affiliation(s)
- J B O'Connor
- Duke University Medical Center, Durham, NC 27710, USA
| | | |
Collapse
|
25
|
Abstract
BACKGROUND Although experts have demonstrated the efficacy of endoscopic retrograde cholangiopancreatography (ERCP) in cholangitis, the effectiveness of ERCP in unselected patients has not been measured. The aim was to investigate the clinical impact of ERCP performed at any time and of early ERCP (within 24 hours of admission) in patients with a primary discharge diagnosis of cholangitis. METHODS A retrospective record review of patients admitted to eight area hospitals with an International Classification of Diseases (ICD)-9 diagnosis consistent with cholangitis was performed. Extracted data included clinical characteristics, ERCP findings, and patient outcome. The associations of ERCP overall and early ERCP with length of stay were examined. Confounding factors including severity of illness, etiology of cholangitis, and hospital type were adjusted for in a multivariate analysis. RESULTS A total of 116 patients were studied. ERCP was performed in 71 patients with endoscopic therapy administered in 57 (80%). ERCP overall was not associated with any change in length of hospital stay. However, compared with other invasive biliary procedures, ERCP was associated with a shorter hospital stay (median 5 vs. 9.5 days, p = 0.01) and a 36% (95% CI [5%, 57%]) reduction in severity-adjusted length of stay. Patients who had early ERCP had a significantly shorter hospital stay than those who had delayed ERCP (median 4 vs. 7 days, p < 0.005) and early ERCP was associated with a 34% (95% CI [11%, 48%]) reduction in severity-adjusted length of stay. CONCLUSION Early ERCP may be an effective strategy for shortening the length of stay in patients hospitalized with cholangitis.
Collapse
Affiliation(s)
- A Chak
- Divisions of Gastroenterology, University Hospitals of Cleveland and MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio 44106-1736, USA
| | | | | | | | | | | |
Collapse
|
26
|
Dumot JA, Conwell DL, O'Connor JB, Ferguson DR, Vargo JJ, Barnes DS, Shay SS, Sterling MJ, Horth KS, Issa K, Ponsky JL, Zuccaro G. Pretreatment with methylprednisolone to prevent ERCP-induced pancreatitis: a randomized, multicenter, placebo-controlled clinical trial. Am J Gastroenterol 1998; 93:61-5. [PMID: 9448176 DOI: 10.1111/j.1572-0241.1998.061_c.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.6] [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] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Pancreatitis remains the major complication of endoscopic retrograde cholangiopancreatography (ERCP). Uncontrolled data suggest a lower incidence of pancreatitis in patients with a history of iodine sensitivity when given pretreatment with corticosteroids. We conducted a clinical trial to assess the efficacy of a commonly prescribed corticosteroid, methylprednisolone, to prevent ERCP-induced pancreatitis. METHODS Patients were entered into a randomized, multicenter, double-blind, placebo-controlled study of intravenous methylprednisolone (125 mg) versus a saline placebo immediately before the ERCP. All patients were evaluated for early and late complications. RESULTS Two hundred eighty-six patients were randomized. Thirty-one randomized patients were excluded for technical reasons at the time of ERCP. Overall, the incidence of pancreatitis was 16 of 129 (12.4%, 95% CI: 6.7-18.1%) in the methylprednisolone group and 11 of 126 (8.7%, 95% CI: 4.4-15.1%) in the placebo group, which was not significantly different (p = 0.34). Although there was a higher rate of sphincterotomy performed in the methylprednisolone group compared to the control group (31.8% vs 16.8%, p = 0.005), the incidence of pancreatitis was not different when patients undergoing sphincterotomy were analyzed separately (13.6% in the methylprednisolone group and 9.6% in the placebo group,p = 0.50). There was no significant difference between the two groups for those with ERCP-induced pancreatitis in hospital length of stay (p = 0.22), days of parenteral analgesia (p = 0.09), or days of parenteral nutrition (p = 0.15). CONCLUSION Intravenous methylprednisolone is not beneficial in preventing ERCP-induced pancreatitis.
Collapse
Affiliation(s)
- J A Dumot
- Department of Gastroenterology, Cleveland Clinic Foundation, Ohio 44195, USA
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Abstract
We describe an unusual case of major small-bowel bleeding and intussusception due to jejunal metastases from a large-cell type carcinoma of the lung. Review of the surprisingly frequent case reports of small bowel metastases from primary lung tumors indicates that there is only one prior case report of intussusception and that ours is the first description of major intestinal hemorrhage due to metastatic pulmonary carcinoma.
Collapse
Affiliation(s)
- K Issa
- Department of Medicine, Case Western Reserve University, Cleveland, Ohio 44109-1998
| | | |
Collapse
|
28
|
|