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Kozlowski KM, Rosston PA, Park AC, Hakimi AA, Socolovsky L, Wong BJF. A Thirteen-Year Analysis of Facial Fractures among Professional Soccer Players. Facial Plast Surg 2024; 40:120-126. [PMID: 36509105 DOI: 10.1055/a-1996-7595] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
This study aims to identify the epidemiology and effects of facial fractures on return to play (RTP) in Major League Soccer (MLS) and the English Premier League (EPL). A total of 39 MLS players and 40 EPL players who sustained facial fractures from 2007 to 2019 were identified. Data on player demographics, the injury, and the impact of their injury on RTP were collected. Elbow-to-head was the most common mechanism of injury (20.3%). The most common fracture involved the nasal bone (48.3%). Most players (90%) RTP the same season. Players who sustained nasal fractures missed significantly fewer games (p < 0.001) than those who suffered other craniofacial fractures. Players treated surgically missed significantly more games (3.21 vs. 0.71, p = 0.006) and days (30.1 vs. 8.70, p = 0.002) than those managed nonoperatively. Significantly more EPL players who sustained facial fractures wore headgear upon RTP compared to MLS players (82% vs. 56%, p <0 .01). Most professional soccer players who sustain a facial fracture RTP the same season, but their recovery time can vary depending on the type of fracture, injury management, or injury severity. Our findings can help inform future craniofacial injury management as well as guidelines on player safety and fracture prevention.
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Affiliation(s)
- Konrad M Kozlowski
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, California
| | | | - Asher C Park
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, California
| | - Amir A Hakimi
- Department of Otolaryngology - Head and Neck Surgery, Medstar Georgetown University Hospital, Washington, District of Columbia
| | - Leandro Socolovsky
- Department of Otolaryngology - Head and Neck Surgery, Medstar Georgetown University Hospital, Washington, District of Columbia
| | - Brian J-F Wong
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, California
- Department of Biomedical Engineering, University of California, Irvine, Irvine, California
- Department of Otolaryngology - Head & Neck Surgery, University of California - Irvine, Orange, California
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Kozlowski KM, Jalaeian H, Travis LM, Zikria JF. A comparative analysis of infection and complication rates between single- and double-lumen ports. Infect Control Hosp Epidemiol 2024:1-5. [PMID: 38272652 DOI: 10.1017/ice.2024.1] [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: 01/27/2024]
Abstract
OBJECTIVE Port-a-caths are implanted intravascular chest ports that enable venous access. With more port placements performed by interventional radiologists, it is important to discern differences in infection and complication rates between double- and single-lumen ports. METHODS We retrospectively reviewed 1,385 port placements over 2 years at the University of Miami. Patients were grouped by single- or double-lumen ports. Data on duration of catheter stay, bloodstream infections, malfunctions, and other complications (fibrin sheath, thrombosis, catheter malposition) were collected. Multivariate Cox regression was performed to identify variables predicting port infection. RESULTS The mean patient age was 58.8 years; the mean BMI was 26.9 kg/m2; and 61.5% of these patients were female. Our search revealed 791 double-lumen ports (57.1%) and 594 single-lumen ports (42.9%). The median follow-up was 668 days (range, 2-1,297). Double-lumen ports were associated with significantly higher rates of bacteremia (2.78% vs 0.84%; P = .02), port malfunction (8.3% vs 2.0%; P < .001), fibrin sheath formation (2.2% vs 0.5%; P < .02), catheter tip malposition (1.0% vs 0; P = .01), and catheter-associated thrombosis (1.4% vs 0; P = .003). Multivariate Cox regression analysis, after adjusting for other variables, showed that double-lumen chest ports had 2.98 times (95% confidence interval, 1.12-7.94) the hazard rate of single-lumen ports for developing bloodstream infection (P = .029). CONCLUSIONS Double-lumen chest ports are associated with increased risk for bloodstream infection, malfunction, fibrin sheath formation, catheter tip malposition, and catheter-associated thrombosis. Interventional radiologists may consider placing single-lumen ports if clinically feasible; however, future studies are needed to determine clinical significance. The study limitations included the retrospective study design and the potential loss of patient follow-up.
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Affiliation(s)
- Konrad M Kozlowski
- Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida
| | - Hamed Jalaeian
- Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida
| | - Levi M Travis
- Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida
| | - Joseph F Zikria
- Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida
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Kozlowski KM, Sharma GK, Chen JJ, Qi L, Osann K, Jing JC, Ahuja GS, Heidari AE, Chung PS, Kim S, Chen Z, Wong BJF. Dynamic programming and automated segmentation of optical coherence tomography images of the neonatal subglottis: enabling efficient diagnostics to manage subglottic stenosis. J Biomed Opt 2019; 24:1-8. [PMID: 31493317 PMCID: PMC6732661 DOI: 10.1117/1.jbo.24.9.096001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 08/20/2019] [Indexed: 05/25/2023]
Abstract
Subglottic stenosis (SGS) is a challenging disease to diagnose in neonates. Long-range optical coherence tomography (OCT) is an optical imaging modality that has been described to image the subglottis in intubated neonates. A major challenge associated with OCT imaging is the lack of an automated method for image analysis and micrometry of large volumes of data that are acquired with each airway scan (1 to 2 Gb). We developed a tissue segmentation algorithm that identifies, measures, and conducts image analysis on tissue layers within the mucosa and submucosa and compared these automated tissue measurements with manual tracings. We noted small but statistically significant differences in thickness measurements of the mucosa and submucosa layers in the larynx (p < 0.001), subglottis (p = 0.015), and trachea (p = 0.012). The automated algorithm was also shown to be over 8 times faster than the manual approach. Moderate Pearson correlations were found between different tissue texture parameters and the patient’s gestational age at birth, age in days, duration of intubation, and differences with age (mean age 17 days). Automated OCT data analysis is necessary in the diagnosis and monitoring of SGS, as it can provide vital information about the airway in real time and aid clinicians in making management decisions for intubated neonates.
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Affiliation(s)
- Konrad M. Kozlowski
- University of California Irvine, Beckman Laser Institute, Irvine, California, United States
| | - Giriraj K. Sharma
- University of California Irvine, Department of Otolaryngology-Head and Neck Surgery, Orange, California, United States
| | - Jason J. Chen
- University of California Irvine, Beckman Laser Institute, Irvine, California, United States
- University of California Irvine, Department of Biomedical Engineering, Irvine, California, United States
| | - Li Qi
- Southern Medical University, School of Biomedical Engineering, Guangzhou, China
| | - Kathryn Osann
- University of California Irvine, Department of Otolaryngology-Head and Neck Surgery, Orange, California, United States
- University of California Irvine, Department of Biomedical Engineering, Irvine, California, United States
| | - Joseph C. Jing
- University of California Irvine, Beckman Laser Institute, Irvine, California, United States
- University of California Irvine, Department of Biomedical Engineering, Irvine, California, United States
| | - Gurpreet S. Ahuja
- University of California Irvine, Department of Otolaryngology-Head and Neck Surgery, Orange, California, United States
- Children’s Hospital of Orange County, Orange, California, United States
| | - Andrew E. Heidari
- University of California Irvine, Beckman Laser Institute, Irvine, California, United States
| | - Phil-Sang Chung
- Dankook University, Beckman Laser Institute Korea, Cheoan, Republic of Korea
| | - Sehwan Kim
- Dankook University, Beckman Laser Institute Korea, Cheoan, Republic of Korea
- Dankook University, School of Medicine, Department of Biomedical Engineering, Cheoan, Republic of Korea
| | - Zhongping Chen
- University of California Irvine, Beckman Laser Institute, Irvine, California, United States
- University of California Irvine, Department of Biomedical Engineering, Irvine, California, United States
| | - Brian J.-F. Wong
- University of California Irvine, Beckman Laser Institute, Irvine, California, United States
- University of California Irvine, Department of Otolaryngology-Head and Neck Surgery, Orange, California, United States
- University of California Irvine, Department of Biomedical Engineering, Irvine, California, United States
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Kulkarni DH, McDonald KG, Knoop KA, Gustafsson JK, Kozlowski KM, Hunstad DA, Miller MJ, Newberry RD. Goblet cell associated antigen passages are inhibited during Salmonella typhimurium infection to prevent pathogen dissemination and limit responses to dietary antigens. Mucosal Immunol 2018; 11:1103-1113. [PMID: 29445136 PMCID: PMC6037413 DOI: 10.1038/s41385-018-0007-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 12/19/2017] [Accepted: 12/26/2017] [Indexed: 02/04/2023]
Abstract
Dietary antigen acquisition by lamina propria (LP) dendritic cells (DCs) is crucial to induce oral tolerance and maintain homeostasis. However, encountering innocuous antigens during infection can lead to inflammatory responses, suggesting processes may limit steady-state luminal antigen capture during infection. We observed that goblet cell (GC) associated antigen passages (GAPs), a steady-state pathway delivering luminal antigens to LP-DCs, are inhibited during Salmonella infection. GAP inhibition was mediated by IL-1β. Infection abrogated luminal antigen delivery and antigen-specific T cell proliferation in the mesenteric lymph node (MLN). Antigen-specific T cell proliferation to dietary antigen was restored by overriding GAP suppression; however, this did not restore regulatory T cell induction, but induced inflammatory T cell responses. Salmonella translocation to the MLN required GCs and correlated with GAPs. Genetic manipulations overriding GAP suppression, or antibiotics inducing colonic GAPs, but not antibiotics that do not, increased dissemination and worsened outcomes independent of luminal pathogen burden. Thus, steady-state sampling pathways are suppressed during infection to prevent responses to dietary antigens, limit pathogen entry, and lessen the disease. Moreover, antibiotics may worsen Salmonella infection by means beyond blunting gut microbiota colonization resistance, providing new insight into how precedent antibiotic use aggravates enteric infection.
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Affiliation(s)
- Devesha H Kulkarni
- Department of Internal Medicine, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - Keely G McDonald
- Department of Internal Medicine, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - Kathryn A Knoop
- Department of Internal Medicine, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - Jenny K Gustafsson
- Department of Internal Medicine, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - Konrad M Kozlowski
- Department of Internal Medicine, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - David A Hunstad
- Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO, 63110, USA
- Department of Molecular Microbiology, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - Mark J Miller
- Department of Internal Medicine, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - Rodney D Newberry
- Department of Internal Medicine, Washington University School of Medicine, Saint Louis, MO, 63110, USA.
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