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Handelsman Y, Jellinger PS, Guerin CK, Bloomgarden ZT, Brinton EA, Budoff MJ, Davidson MH, Einhorn D, Fazio S, Fonseca VA, Garber AJ, Grunberger G, Krauss RM, Mechanick JI, Rosenblit PD, Smith DA, Wyne KL. Consensus Statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the Management of Dyslipidemia and Prevention of Cardiovascular Disease Algorithm - 2020 Executive Summary. Endocr Pract 2021; 26:1196-1224. [PMID: 33471721 DOI: 10.4158/cs-2020-0490] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 08/10/2020] [Indexed: 12/12/2022]
Abstract
The treatment of lipid disorders begins with lifestyle therapy to improve nutrition, physical activity, weight, and other factors that affect lipids. Secondary causes of lipid disorders should be addressed, and pharmacologic therapy initiated based on a patient's risk for atherosclerotic cardiovascular disease (ASCVD). Patients at extreme ASCVD risk should be treated with high-intensity statin therapy to achieve a goal low-density lipoprotein cholesterol (LDL-C) of <55 mg/dL, and those at very high ASCVD risk should be treated to achieve LDL-C <70 mg/dL. Treatment for moderate and high ASCVD risk patients may begin with a moderate-intensity statin to achieve an LDL-C <100 mg/dL, while the LDL-C goal is <130 mg/dL for those at low risk. In all cases, treatment should be intensified, including the addition of other LDL-C-lowering agents (i.e., proprotein convertase subtilisin/kexin type 9 inhibitors, ezetimibe, colesevelam, or bempedoic acid) as needed to achieve treatment goals. When targeting triglyceride levels, the desirable goal is <150 mg/dL. Statin therapy should be combined with a fibrate, prescription-grade omega-3 fatty acid, and/or niacin to reduce triglycerides in all patients with triglycerides ≥500 mg/dL, and icosapent ethyl should be added to a statin in any patient with established ASCVD or diabetes with ≥2 ASCVD risk factors and triglycerides between 135 and 499 mg/dL to prevent ASCVD events. Management of additional risk factors such as elevated lipoprotein(a) and statin intolerance is also described.
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Affiliation(s)
- Yehuda Handelsman
- Medical Director & Principal Investigator, Metabolic Institute of America, Tarzana, California.
| | - Paul S Jellinger
- Professor of Clinical Medicine, Voluntary Faculty, University of Miami Miller School of Medicine, Center for Diabetes & Endocrine Care, Hollywood, Florida
| | - Chris K Guerin
- Clinical Assistant Professor of Medicine, Voluntary Faculty, University of California San Diego, San Diego, California
| | - Zachary T Bloomgarden
- Editor, the Journal of Diabetes, Clinical Professor, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Eliot A Brinton
- President, Utah Lipid Center, Salt Lake City, Utah, Past President, American Board of Clinical Lipidology, Torrance, California
| | - Matthew J Budoff
- Professor of Medicine, UCLA Endowed Chair of Preventive Cardiology, Los Angeles Biomedical Research Institute, Torrance, California
| | - Michael H Davidson
- Professor, Director of the Lipid Clinic, University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Daniel Einhorn
- Associate Editor, the Journal of Diabetes, Medical Director, Scripps Whittier Diabetes Institute, Clinical Professor of Medicine, UCSD, President, Diabetes and Endocrine Associates, San Diego, California
| | - Sergio Fazio
- The William and Sonja Connor Chair of Preventive Cardiology, Professor of Medicine and Physiology & Pharmacology, Director, Center for Preventive Cardiology, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Vivian A Fonseca
- Professor of Medicine and Pharmacology, Assistant Dean for Clinical Research, Tullis Tulane Alumni Chair in Diabetes, Chief, Section of Endocrinology, Tulane University Health Sciences Center, New Orleans, Louisiana
| | - Alan J Garber
- Professor, Departments of Medicine, Biochemistry and Cell and Molecular Biology, Baylor College of Medicine, Houston, Texas
| | - George Grunberger
- Chairman, Grunberger Diabetes Institute, Clinical Professor, Internal Medicine and Molecular Medicine & Genetics, Wayne State University School of Medicine, Professor, Internal Medicine, Oakland University William Beaumont School of Medicine, Visiting Professor, Internal Medicine, First Faculty of Medicine, Charles University, Prague, Czech Republic, Past President, American Association of Clinical Endocrinologists, Bloomfield Hills, Michigan
| | - Ronald M Krauss
- Professor of Pediatrics and Medicine, UCSF, Adjunct Professor, Department of Nutritional Sciences, University of California, Berkeley, Dolores Jordan Endowed Chair, UCSF Benioff Children's Hospital Oakland, New York, New York
| | - Jeffrey I Mechanick
- Professor of Medicine, Medical Director, The Marie-Josee and Henry R. Kravis Center for Clinical Cardiovascular Health at Mount Sinai Heart, Director, Metabolic Support, Divisions of Cardiology and Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai Heart, Director, Metabolic Support, Divisions of Cardiology and Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Paul D Rosenblit
- Clinical Professor, Medicine (Division of Endocrinology, Diabetes, Metabolism), University California, Irvine, School of Medicine, Irvine, California, Co-Director, Diabetes Out-Patient Clinic, UCI Medical Center, Orange, California, Director & Site Principal Investigator, Diabetes/Lipid Management & Research Center, Huntington Beach, California
| | - Donald A Smith
- Endocrinologist, Clinical Lipidologist, Associate Professor of Medicine, Icahn School of Medicine Mount Sinai, Director Lipids and Metabolism, Mount Sinai Heart, New York, New York
| | - Kathleen L Wyne
- Director, Adult Type 1 Diabetes Program, Division of Endocrinology, Diabetes, and Metabolism, The Ohio State University Wexner Medical Center, Columbus, Ohio
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Dodson C, Richards TJ, Smith DA, Ramaiya NH. Tyrosine Kinase Inhibitor Therapy for Brain Metastases in Non-Small-Cell Lung Cancer: A Primer for Radiologists. AJNR Am J Neuroradiol 2020; 41:738-750. [PMID: 32217548 DOI: 10.3174/ajnr.a6477] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 01/06/2020] [Indexed: 12/19/2022]
Abstract
Treatment options for patients who develop brain metastases secondary to non-small-cell lung cancer have rapidly expanded in recent years. As a key adjunct to surgical and radiation therapy options, systemic therapies are now a critical component of the oncologic management of metastatic CNS disease in many patients with non-small-cell lung cancer. The aim of this review article was to provide a guide for radiologists, outlining the role of systemic therapies in metastatic non-small-cell lung cancer, with a focus on tyrosine kinase inhibitors. The critical role of the blood-brain barrier in the development of systemic therapies will be described. The final sections of this review will provide an overview of current imaging-based guidelines for therapy response. The utility of the Response Assessment in Neuro-Oncology criteria will be discussed, with a focus on how to use the response criteria in the assessment of patients treated with systemic and traditional therapies.
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Affiliation(s)
- C Dodson
- From the Department of Radiology (C.D., T.J.R., D.A.S., N.H.R.), University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - T J Richards
- From the Department of Radiology (C.D., T.J.R., D.A.S., N.H.R.), University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
- Department of Radiology and Imaging Sciences (T.J.R.), University of Utah Hospital, Salt Lake City, Utah
| | - D A Smith
- From the Department of Radiology (C.D., T.J.R., D.A.S., N.H.R.), University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - N H Ramaiya
- From the Department of Radiology (C.D., T.J.R., D.A.S., N.H.R.), University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
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Noureldine MHA, Pressman E, Krafft PR, Smith DA, Greenberg MS, Alikhani P. Minimally Invasive Lateral Retropleural and Retroperitoneal Approaches in Patients with Thoracic and Lumbar Osteomyelitis: Description of the Techniques and a Series of 14 Patients. World Neurosurg 2020; 139:e166-e181. [PMID: 32272270 DOI: 10.1016/j.wneu.2020.03.172] [Citation(s) in RCA: 4] [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] [Received: 02/17/2020] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND The growing interest in minimally invasive approaches to the thoracic and lumbar spine is mostly secondary to the high surgical morbidity and complication rates associated with conventional open approaches. The objective was to report the largest series of patients with thoracic and lumbar vertebral osteomyelitis who underwent multilevel corpectomies using the minimally invasive lateral (MIL) retropleural and retroperitoneal approaches. METHODS The surgical techniques of the MIL approaches are illustrated and described in detail. The MIL retropleural approach was performed in 9 patients, MIL retroperitoneal approach in 3 patients, and combined MIL retropleural/retroperitoneal approach in 2 patients with thoracic, lumbar and thoracolumbar vertebral osteomyelitis, respectively. RESULTS Multilevel corpectomies were successfully accomplished in all 14 patients using the MIL approaches (11 patients with 2-level corpectomy, 2 patients with 3-level corpectomy, and 1 patient with extension of a 3-level corpectomy to 6 levels). Correction of kyphotic deformity was achieved postoperatively in all 14 patients and remained stable with no proximal junctional kyphosis for a median of 10 months of follow-up on 10 patients; 4 patients were lost to follow-up after discharge from the hospital. Posterior instrumentation was performed in 12 patients to further support the spinal alignment. CONCLUSIONS The MIL retropleural and retroperitoneal approaches described in this manuscript are feasible and safe in achieving multilevel corpectomies, anterior column reconstruction, and spinal deformity correction in patients with thoracic, lumbar, and thoracolumbar vertebral osteomyelitis.
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Affiliation(s)
- Mohammad Hassan A Noureldine
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Institute for Brain Protection Sciences, Johns Hopkins All Children's Hospital, Saint Petersburg, Florida, USA
| | - Elliot Pressman
- Department of Neurosurgery, University of South Florida Morsani College of Medicine, Tampa General Hospital, Tampa, Florida, USA
| | - Paul R Krafft
- Department of Neurosurgery, University of South Florida Morsani College of Medicine, Tampa General Hospital, Tampa, Florida, USA
| | - Donald A Smith
- Department of Neurosurgery, University of South Florida Morsani College of Medicine, Tampa General Hospital, Tampa, Florida, USA
| | - Mark S Greenberg
- Department of Neurosurgery, University of South Florida Morsani College of Medicine, Tampa General Hospital, Tampa, Florida, USA
| | - Puya Alikhani
- Department of Neurosurgery, University of South Florida Morsani College of Medicine, Tampa General Hospital, Tampa, Florida, USA.
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Smith DA. Review: Long-chain ω-3 fatty acids have no effect on mortality or overall cardiovascular events. Ann Intern Med 2018; 169:JC50. [PMID: 30452557 DOI: 10.7326/acpjc-2018-169-10-050] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Donald A. Smith
- Icahn School of Medicine at Mount SinaiNew York City, New York, USA
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Smith DA. Review: In adults, increasing ω-6 fatty acid intake does not reduce mortality or overall cardiovascular events. Ann Intern Med 2018; 169:JC51. [PMID: 30452558 DOI: 10.7326/acpjc-2018-169-10-051] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Donald A. Smith
- Icahn School of Medicine at Mount SinaiNew York City, New York, USA
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Zafar MU, Smith DA, Baber U, Sartori S, Chen K, Lam DW, Linares-Koloffon CA, Rey-Mendoza J, Jimenez Britez G, Escolar G, Fuster V, Badimon JJ. Impact of Timing on the Functional Recovery Achieved With Platelet Supplementation After Treatment With Ticagrelor. Circ Cardiovasc Interv 2018; 10:CIRCINTERVENTIONS.117.005120. [PMID: 28768756 DOI: 10.1161/circinterventions.117.005120] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 05/30/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND American College of Cardiology/American Heart Association guidelines advise waiting 5 to 7 days before operating on P2Y12 inhibitor-treated acute coronary syndrome patients, to allow dissipation of its antiplatelet effects. Platelet transfusion is often used to restore hemostasis during operations, but its effectiveness and optimal timing are unclear. We investigated the degree of functional gains obtained from platelet supplementation after loading and maintenance of dual antiplatelet therapy with ticagrelor and the influence of timing on this strategy. METHODS AND RESULTS After baseline platelet testing (Multiplate Analyzer and VerifyNow), cardiovascular disease patients (n=20; 56.9±7.9 years; 65% men; 75% diabetic) received dual antiplatelet therapy as a single loading dose (ticagrelor 180 mg plus aspirin 325 mg) and as daily/maintenance treatment for 5 to 7 days (maintenance therapy: ticagrelor 90 mg BID plus aspirin 81 mg QD). At 4, 6, 24, and 48 hours from (last) dosing, patients' blood samples were supplemented with concentrated platelets from healthy donors in vitro, raising platelet counts by 0% (unsupplemented control), 25%, 50%, and 75%, and the function retested. Reactivity in supplemented samples was compared with respective 0% sample and with the pretreatment baseline. Results under loading dose and maintenance therapy regimens were nearly identical. Platelet reactivity was higher (P<0.05) in nearly all supplemented samples versus respective controls. Aggregations with supplementation were 59% to 79% of baseline at 24 hours and equal to baseline at 48 hours. CONCLUSIONS Platelet reactivity of ticagrelor-treated patients can be restored using concentrated platelets after a loading dose/maintenance therapy in a time-dependent manner under in vitro testing. Although statistically significant improvements are evident 6 hours after (last) dosing, ≥24 hours maybe needed for clinically meaningful restoration in platelet function. CLINICAL TRIAL REGISTRATION URL: https://clinicaltrials.gov. Unique identifier: NCT02201394.
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Affiliation(s)
- M Urooj Zafar
- From the Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (M.U.Z., D.A.S., U.B., S.S., K.C., D.W.L., C.A.L.-K., J.R.-M., G.J.B., V.F., J.J.B.); and Department of Hematopathology, Hospital Clinic, Barcelona, Spain (G.E.)
| | - Donald A Smith
- From the Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (M.U.Z., D.A.S., U.B., S.S., K.C., D.W.L., C.A.L.-K., J.R.-M., G.J.B., V.F., J.J.B.); and Department of Hematopathology, Hospital Clinic, Barcelona, Spain (G.E.)
| | - Usman Baber
- From the Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (M.U.Z., D.A.S., U.B., S.S., K.C., D.W.L., C.A.L.-K., J.R.-M., G.J.B., V.F., J.J.B.); and Department of Hematopathology, Hospital Clinic, Barcelona, Spain (G.E.)
| | - Samantha Sartori
- From the Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (M.U.Z., D.A.S., U.B., S.S., K.C., D.W.L., C.A.L.-K., J.R.-M., G.J.B., V.F., J.J.B.); and Department of Hematopathology, Hospital Clinic, Barcelona, Spain (G.E.)
| | - Kevin Chen
- From the Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (M.U.Z., D.A.S., U.B., S.S., K.C., D.W.L., C.A.L.-K., J.R.-M., G.J.B., V.F., J.J.B.); and Department of Hematopathology, Hospital Clinic, Barcelona, Spain (G.E.)
| | - David W Lam
- From the Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (M.U.Z., D.A.S., U.B., S.S., K.C., D.W.L., C.A.L.-K., J.R.-M., G.J.B., V.F., J.J.B.); and Department of Hematopathology, Hospital Clinic, Barcelona, Spain (G.E.)
| | - Carlos A Linares-Koloffon
- From the Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (M.U.Z., D.A.S., U.B., S.S., K.C., D.W.L., C.A.L.-K., J.R.-M., G.J.B., V.F., J.J.B.); and Department of Hematopathology, Hospital Clinic, Barcelona, Spain (G.E.)
| | - Juan Rey-Mendoza
- From the Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (M.U.Z., D.A.S., U.B., S.S., K.C., D.W.L., C.A.L.-K., J.R.-M., G.J.B., V.F., J.J.B.); and Department of Hematopathology, Hospital Clinic, Barcelona, Spain (G.E.)
| | - Gustavo Jimenez Britez
- From the Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (M.U.Z., D.A.S., U.B., S.S., K.C., D.W.L., C.A.L.-K., J.R.-M., G.J.B., V.F., J.J.B.); and Department of Hematopathology, Hospital Clinic, Barcelona, Spain (G.E.)
| | - Gines Escolar
- From the Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (M.U.Z., D.A.S., U.B., S.S., K.C., D.W.L., C.A.L.-K., J.R.-M., G.J.B., V.F., J.J.B.); and Department of Hematopathology, Hospital Clinic, Barcelona, Spain (G.E.)
| | - Valentin Fuster
- From the Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (M.U.Z., D.A.S., U.B., S.S., K.C., D.W.L., C.A.L.-K., J.R.-M., G.J.B., V.F., J.J.B.); and Department of Hematopathology, Hospital Clinic, Barcelona, Spain (G.E.)
| | - Juan J Badimon
- From the Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (M.U.Z., D.A.S., U.B., S.S., K.C., D.W.L., C.A.L.-K., J.R.-M., G.J.B., V.F., J.J.B.); and Department of Hematopathology, Hospital Clinic, Barcelona, Spain (G.E.).
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Zafar MU, Santos-Gallego CG, Smith DA, Halperin JL, Badimon JJ. Dronedarone exerts anticoagulant and antiplatelet effects independently of its antiarrhythmic actions. Atherosclerosis 2017; 266:81-86. [DOI: 10.1016/j.atherosclerosis.2017.09.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 09/13/2017] [Accepted: 09/27/2017] [Indexed: 01/08/2023]
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Smith DA. Review: Sulfonylureas are associated with overall mortality and CV events vs other antihyperglycemics in T2DM. Ann Intern Med 2017; 166:JC40. [PMID: 28418542 DOI: 10.7326/acpjc-2017-166-8-040] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Donald A Smith
- Icahn School of Medicine at Mount SinaiNew York, New York, USA
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Affiliation(s)
- C Jasani
- University Department of Medicine, Glasgow, and MRC Mineral Metabolism Unit, Leeds
| | - B E C Nordin
- University Department of Medicine, Glasgow, and MRC Mineral Metabolism Unit, Leeds
| | - D A Smith
- University Department of Medicine, Glasgow, and MRC Mineral Metabolism Unit, Leeds
| | - I Swanson
- University Department of Medicine, Glasgow, and MRC Mineral Metabolism Unit, Leeds
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Smith DA. Incretin-based drugs were not linked to HF hospitalization compared with other oral antidiabetic drug combinations. Ann Intern Med 2016; 165:JC11. [PMID: 27429313 DOI: 10.7326/acpjc-2016-165-2-011] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Abstract
OBJECTIVE: To summarize the literature describing nonneuroleptic treatments of unacceptably disruptive behavior in chronically institutionalized psychiatric patients with mental retardation, autism, organic brain syndrome, and dementia. DATA SOURCES: Relevant articles were identified from a MEDLINE search of the above diagnoses linked with “aggression” and “psychomotor agitation.” Additional references were found in the bibliographies of these articles. STUDY SELECTION/DATA EXTRACTION: The studies reviewed were limited to prospective evaluations of nonneuroleptic drug therapy of these behavior disturbances. Case reports, case series, and retrospective studies were excluded. Studies of patients with schizophrenia, affective disorders, and personality disorders were also excluded. DATA SYNTHESIS: Studies of lithium, beta-blockers, carbamazepine, benzodiazepines, and buspirone were adequate for review. As a rule, these studies are hampered by poor design. The lithium studies suggest that mentally retarded patients with behavior disturbances may respond to lithium treatment. The beta-blocker studies suggest improvement in patients with mental retardation, autism, organic brain syndrome, and dementia. Neuroleptic discontinuation or a decrease in dose was possible in some patients. The carbamazepine studies were inconclusive. Carbamazepine should be reserved for patients with concomitant seizure disorders. Benzodiazepines were helpful in treating elderly demented patients. Thus far, buspirone has been evaluated in only a few, poorly designed studies and is not yet recommended for treatment of behavior disturbances. CONCLUSIONS: Legislation has restricted the use of neuroleptics in many patients receiving long-term healthcare. Despite the questionable validity of the studies reviewed, lithium, beta-blockers, carbamazepine, and benzodiazepines may be considered as alternatives to neuroleptics in selected cases.
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Affiliation(s)
- D A Smith
- Division of Clinical Pharmacy, College of Pharmacy, University of Iowa, Iowa City 52242
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Root AW, Smith DA, Pavan PR. BB Shots Within the Sella Turcica. J Neuroimaging 2016. [DOI: 10.1111/jon199333198] [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: 11/26/2022] Open
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Smith DA. Lipoprotein-X in a Patient with Lymphoplasmacytic Sclerosing Cholangitis: An Unusual Cause of Secondary Hypercholesterolemia. AACE Clin Case Rep 2016. [DOI: 10.4158/ep15726.co] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Smith DA, Steele A, Fogel ML. Pigment production and isotopic fractionations in continuous culture: okenone producing purple sulfur bacteria Part II. Geobiology 2015; 13:292-301. [PMID: 25857754 DOI: 10.1111/gbi.12135] [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] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 01/14/2015] [Indexed: 06/04/2023]
Abstract
Okenone is a carotenoid pigment unique to certain members of Chromatiaceae, the dominant family of purple sulfur bacteria (PSB) found in euxinic photic zones. Diagenetic alteration of okenone produces okenane, the only recognized molecular fossil unique to PSB. The in vivo concentrations of okenone and bacteriochlorophyll a (Bchl a) on a per cell basis were monitored and quantified as a function of light intensity in continuous cultures of the purple sulfur bacterium Marichromatium purpuratum (Mpurp1591). We show that okenone-producing PSB have constant bacteriochlorophyll to carotenoid ratios in light-harvesting antenna complexes. The in vivo concentrations of Bchl a, 0.151 ± 0.012 fmol cell(-1), and okenone, 0.103 ± 0.012 fmol cell(-1), were not dependent on average light intensity (10-225 Lux) at both steady and non-steady states. This observation revealed that in autotrophic continuous cultures of Mpurp1591, there was a constant ratio for okenone to Bchl a of 1:1.5. Okenone was therefore constitutively produced in planktonic cultures of PSB, regardless of light intensity. This confirms the legitimacy of okenone as a signature for autotrophic planktonic PSB and by extrapolation water column euxinia. We measured the δ(13)C, δ(15)N, and δ(34)S bulk biomass values from cells collected daily and determined the isotopic fractionations of Mpurp1591. There was no statistical relationship in the bulk isotope measurements or stable isotope fractionations to light intensity or cell density under steady and non-steady-state conditions. The carbon isotope fractionation between okenone and Bchl a with respect to overall bulk biomass ((13)ε pigment - biomass) was 2.2 ± 0.4‰ and -4.1 ± 0.9‰, respectively. The carbon isotopic fractionation (13ε pigment-CO2) for the production of pigments in PSB is more variable than previously thought with our reported values for okenone at -15.5 ± 1.2‰ and -21.8 ± 1.7‰ for Bchl a.
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Affiliation(s)
- D A Smith
- Department of Earth Sciences, Dartmouth College, Hanover, NH, USA; Geophysical Laboratory of the Carnegie Institution of Washington, Washington, DC, USA
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Smith DA, Steele A, Bowden R, Fogel ML. Ecologically and geologically relevant isotope signatures of C, N, and S: okenone producing purple sulfur bacteria Part I. Geobiology 2015; 13:278-291. [PMID: 25857753 DOI: 10.1111/gbi.12136] [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] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 02/20/2015] [Indexed: 06/04/2023]
Abstract
Purple sulfur bacteria (PSB) are known to couple the carbon, nitrogen, and sulfur cycling in euxinic environments. This is the first study with multiple strains and species of okenone-producing PSB to examine the carbon (C), nitrogen (N), and sulfur (S) metabolisms and isotopic signatures in controlled laboratory conditions, investigating what isotopic fractionations might be recorded in modern environments and the geologic record. PSB play an integral role in the ecology of euxinic environments and produce the unique molecular fossil okenane, derived from the diagenetic alteration of the carotenoid pigment okenone. Cultures of Marichromatium purpuratum 1591 (Mpurp1591) were observed to have carbon isotope fractionations ((13)ε biomass - CO2), via RuBisCO, ranging from -16.1 to -23.2‰ during exponential and stationary phases of growth. Cultures of Thiocapsa marina 5653 (Tmar5653) and Mpurp1591 had a nitrogen isotope fractionation ((15)ε biomass - NH 4) of -15‰, via glutamate dehydrogenase, measured and recorded for the first time in PSB. The δ(34) SVCDT values and amount of stored elemental sulfur for Mpurp1591 cells grown autotrophically and photoheterotrophically were dependent upon their carbon metabolic pathways. We show that PSB may contribute to the isotopic enrichments observed in modern and ancient anoxic basins. In a photoheterotrophic culture of Mpurp1591 that switched to autotrophy once the organic substrate was consumed, there were bulk biomass δ(13)C values that span a broader range than recorded across the Late Devonian, Permian-Triassic, Triassic-Jurassic, and OAE2 mass extinction boundaries. This finding stresses the complexities in interpreting and assigning δ(13)C values to bulk organic matter preserved in the geologic record.
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Affiliation(s)
- D A Smith
- Department of Earth Sciences, Dartmouth College, Hanover, NH, USA; Geophysical Laboratory of the Carnegie Institution of Washington, Washington, DC, USA
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Murray G, Beckman J, Bach K, Smith DA, Dakwar E, Uribe JS. Complications and neurological deficits following minimally invasive anterior column release for adult spinal deformity: a retrospective study. Eur Spine J 2015; 24 Suppl 3:397-404. [PMID: 25850388 DOI: 10.1007/s00586-015-3894-1] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 03/18/2015] [Accepted: 03/19/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Minimally invasive techniques have become increasing popular and are expanding into deformity surgery. The lateral retroperitoneal transpsoas anterior column release (ACR) is a newer minimally invasive alternative to posterior osteotomy techniques for correcting and promoting global spinal alignment. This procedure attempts to avoid the potential complications associated with conventional osteotomies, but has its own subset of unique complications to be discussed in depth. METHODS A retrospective review was performed in all patients who underwent the minimally invasive (MIS) ACR procedure from 2010 to present at our institution. All perioperative and postoperative complications were recorded by an independent reviewer. Demographics, spinopelvic parameters, and operative data were collected. The primary etiologic diagnosis was adult spinal deformity. Spinopelvic parameters were measured based on standing 36-inch scoliosis films. RESULTS Thirty-one patients underwent a total of 47 MIS-ACRs. The mean age of the cohort was 62. Mean follow up was 12 months (range 3-38 months). The average change from in lumbar lordosis (LL) was 17.6°, in pelvic tilt was 4.3°, coronal Cobb was 13.9 and in SVA was 3.8 cm. Of the 47 MIS-ACR procedures, there were 9 (9/47, 19 %) major complications related to the ACR. Iliopsoas weakness was seen in eight patients and retrograde ejaculation in one patient. Only one patient remained with mild motor deficit at the most recent follow-up. No revision surgeries were required for the anterolateral approach. There was no vascular, visceral, or infectious complications associated with the MIS-ACR. CONCLUSION The MIS-ACR is one of the most technically demanding procedures performed from the lateral transpsoas approach. This procedure has the advantage of maintaining and improving spinal global alignment while minimizing blood loss and excessive tissue dissection. It comes with its own unique set of potentially catastrophic complications and should only be performed by surgeons proficient in both deformity correction and the lateral approach.
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Affiliation(s)
- Gisela Murray
- University of South Florida, 2 Tampa General Circle, 7th Floor, Tampa, FL, 33606, USA
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Affiliation(s)
- Donald A Smith
- Associate Professor of Medicine and Preventive Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, Box 1014, New York, NY 10029-6574, USA.
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Gupta A, Smith DA. The 2013 American College of Cardiology/American Heart Association guidelines on treating blood cholesterol and assessing cardiovascular risk: a busy practitioner's guide. Endocrinol Metab Clin North Am 2014; 43:869-92. [PMID: 25432387 DOI: 10.1016/j.ecl.2014.08.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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: 11/19/2022]
Abstract
The 2013 American College of Cardiology/American Heart Association Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults and Guideline on the Assessment of Cardiovascular Risk were released in mid-November 2013. This article explains the guidelines, the risk equations, and their derivations, and addresses criticisms so that practicing physicians may be more comfortable in using the guidelines and the risk equations to inform patients of their atherosclerotic cardiovascular risk and choices to reduce that risk. The article also addresses patient concerns about statin safety if lifestyle changes have been insufficient to reduce their risk.
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Affiliation(s)
- Arpeta Gupta
- Division of Endocrinology, Diabetes, and Bone Diseases, Icahn School of Medicine at Mount Sinai, Box 1055, New York, NY 10029, USA
| | - Donald A Smith
- Mount Sinai Heart, Icahn School of Medicine, Box 1014, 1 Gustave Levy Place, New York, NY 10029-6574, USA.
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Smith DA. ACP Journal Club. Review: statins are not associated with cognitive impairment or dementia in cognitively intact adults. Ann Intern Med 2014; 160:JC11, JC10. [PMID: 24842433 DOI: 10.7326/0003-4819-160-10-201405200-02011] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Smith DA. ACP Journal Club. Review: statins are not associated with cognitive impairment, Alzheimer disease, or dementia. Ann Intern Med 2014; 160:JC10-1. [PMID: 24842432 DOI: 10.7326/0003-4819-160-10-201405200-02010] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Manwaring JC, Bach K, Ahmadian AA, Deukmedjian AR, Smith DA, Uribe JS. Management of sagittal balance in adult spinal deformity with minimally invasive anterolateral lumbar interbody fusion: a preliminary radiographic study. J Neurosurg Spine 2014; 20:515-22. [PMID: 24628129 DOI: 10.3171/2014.2.spine1347] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Minimally invasive (MI) fusion and instrumentation techniques are playing a new role in the treatment of adult spinal deformity. The open pedicle subtraction osteotomy (PSO) and Smith-Petersen osteotomy (SPO) are proven segmental methods for improving regional lordosis and global sagittal parameters. Recently the MI anterior column release (ACR) was introduced as a segmental method for treating sagittal imbalance. There is a paucity of data in the literature evaluating the alternatives to PSO and SPO for sagittal balance correction. Thus, the authors conducted a preliminary retrospective radiographic review of prospectively collected data from 2009 to 2012 at a single institution. The objectives of this study were to: 1) investigate the radiographic effect of MI-ACR on spinopelvic parameters, 2) compare the radiographic effect of MI-ACR with PSO and SPO for treatment of adult spinal deformity, and 3) investigate the radiographic effect of percutaneous posterior spinal instrumentation on spinopelvic parameters when combined with MI transpsoas lateral interbody fusion (LIF) for adult spinal deformity. METHODS Patient demographics and radiographic data were collected for 36 patients (9 patients who underwent MI-ACR and 27 patients who did not undergo MI-ACR). Patients included in the study were those who had undergone at least a 2-level MI-LIF procedure; adequate preoperative and postoperative 36-inch radiographs of the scoliotic curvature; a separate second-stage procedure for the placement of posterior spinal instrumentation; and a diagnosis of degenerative scoliosis (coronal Cobb angle > 10° and/or sagittal vertebral axis > 5 cm). Statistical analysis was performed for normality and significance testing. RESULTS Percutaneous transpedicular spinal instrumentation did not significantly alter any of the spinopelvic parameters in either the ACR group or the non-ACR group. Lateral MI-LIF alone significantly improved coronal Cobb angle by 16°, and the fractional curve significantly improved in a subgroup treated with L5-S1 transforaminal lumbar interbody fusion. Fifteen ACRs were performed in 9 patients and resulted in significant coronal Cobb angle correction, lumbar lordosis correction of 16.5°, and sagittal vertebral axis correction of 4.8 cm per patient. Segmental analysis revealed a 12° gain in segmental lumbar lordosis and a 3.1-cm correction of the sagittal vertebral axis per ACR level treated. CONCLUSIONS The lateral MI-LIF with ACR has the ability to powerfully restore lumbar lordosis and correct sagittal imbalance. This segmental MI surgical technique boasts equivalence to SPO correction of these global radiographic parameters while simultaneously creating additional disc height and correcting coronal imbalance. Addition of posterior percutaneous instrumentation without in situ manipulation or overcorrection does not alter radiographic parameters when combined with the lateral MI-LIF.
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Affiliation(s)
- Jotham C Manwaring
- Department of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, Florida
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Smith DA. ACP Journal Club. A lifestyle intervention did not reduce cardiovascular outcomes in overweight or obese patients with type 2 diabetes. Ann Intern Med 2013; 159:JC4. [PMID: 24126665 DOI: 10.7326/0003-4819-159-8-201310150-02004] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Greene J, Ashburn SM, Razzouk L, Smith DA. Greene et al. respond. Am J Public Health 2013; 103:e4-5. [PMID: 24028224 DOI: 10.2105/ajph.2013.301551] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Jonathan Greene
- At the time of the study, all authors were with Mount Sinai Medical Center, New York, NY
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Ahmadian A, Verma S, Mundis GM, Oskouian RJ, Smith DA, Uribe JS. Minimally invasive lateral retroperitoneal transpsoas interbody fusion for L4-5 spondylolisthesis: clinical outcomes. J Neurosurg Spine 2013; 19:314-20. [PMID: 23889186 DOI: 10.3171/2013.6.spine1340] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [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
OBJECT In this study the authors report on the clinical outcomes, safety, and efficacy of lateral retroperitoneal transpsoas minimally invasive surgery-lumbar interbody fusion (MIS-LIF) at the L4-5 disc space in patients with spondylolisthesis. This approach has become an increasingly popular means of fusion. Its most frequent complication is lumbar plexus injury. Reported complication rates at the L4-5 disc space vary widely in the literature, bringing into question the safety of MIS-LIF for the L4-5 region, especially in patients with spondylolisthesis. METHODS The authors retrospectively reviewed prospectively acquired multicenter databases of patients with Grade I and II L4-5 spondylolisthesis who had undergone elective MIS-LIF between 2008 and 2011. Clinical follow-up had been scheduled for 1, 3, 6, 12, and 24 months postoperatively. Outcome measures included estimated blood loss, operative time, length of hospital stay, integrity of construct, complications, fusion rates, visual analog scale (VAS), Oswestry Disability Index (ODI), and 36-Item Short Form Health Survey (SF-36). RESULTS Eighty-four patients with L4-5 MIS-LIF were identified, 31 of whom met the study inclusion criteria: 26 adults with Grade I and 5 adults with Grade II L4-5 spondylolisthesis who had undergone elective MIS-LIF and subsequent posterior percutaneous pedicle screw fixation without surgical manipulation of the posterior elements (laminectomy, foraminotomy, facetectomy). The study cohort consisted of 9 males (29%) and 22 females (71%) with an average age of 61.5 years. The mean total blood loss was 94 ml (range 20-250 ml). The mean hospital stay and follow-up were 3.5 days and 18.2 months, respectively. The average score on the ODI improved from 50.4 preoperatively to 30.9 at the last follow-up (p < 0.0001). The SF-36 score improved from 38.1 preoperatively to 59.5 at the last follow-up (p < 0.0001). The VAS score improved from 69.9 preoperatively to 38.7 at the last follow-up (p < 0.0001). No motor weakness or permanent deficits were documented in any patient. Correction of deformity did not have any neurological complications. All patients had improvement in anterolisthesis. Residual postoperative listhesis across cases was noted in 4 patients (12.9%). Transient anterior thigh numbness (Sensory Dermal Zone III) was noted in 22.5% of patients. CONCLUSIONS With its established surgical corridors through the retroperitoneum and psoas muscle, the MIS-LIF combined with posterior percutaneous pedicle screw fixation/reduction is a safe, reproducible, and effective technique for patients with symptomatic degenerative spondylolisthesis at the L4-5 vertebral segment.
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Affiliation(s)
- Amir Ahmadian
- Department of Neurosurgery, University of South Florida, Tampa, USA.
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Abstract
Clinical trials continue to produce conflicting results on the effectiveness of fish oils for the primary and secondary prevention of coronary heart disease. Despite many large, well-performed studies, questions still remain, made even more complex by the addition of early revascularization and statins in our coronary heart disease armamentarium. This is complicated by the reality that fish oil production has a measureable impact on reducing fish populations, which in turn has a negative impact on creating a sustainable product. We review the current data for fish oil usage in the primary and secondary prevention of coronary heart disease with an eye toward future studies, and the effects fish oil production has on the environment and efforts that are currently under way to mitigate these effects.
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Traina TA, Hudis C, Seidman A, Gajria D, Gonzalez J, Anthony SP, Smith DA, Chandler JC, Jac J, Youssoufian H, Korth CC, Barrett JA, Sun L, Norton L. Abstract P6-11-10: IBL2001: Phase I/II study of a novel dose-dense schedule of oral indibulin for the treatment of metastastic breast cancer. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p6-11-10] [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: 11/16/2022]
Abstract
Abstract
Background: Indibulin (ZI0-301) is a novel, oral, synthetic small molecule microtubule inhibitor which binds tubulin at a different site than taxanes and vinca alkaloids. Preclinical data demonstrate indibulin does not interact with acetylated (neuronal) tubulins and in clinical studies has not exhibited the neurotoxicity associated with other tubulin binders. Indibulin has potent antitumor activity in human cancer cell lines, including multidrug-, taxane-, and vinblastine-resistant. Norton-Simon modeling based on cell line data suggested that dose dense (dd) administration could optimize efficacy while limiting toxicity.
Methods: Eligible patients (pts) have metastatic or unresectable locally advanced breast cancer, ECOG performance status ≤ 2, adequate organ function, measurable or nonmeasurable disease and any number of prior therapies. Uncontrolled gastrointestinal malabsorption syndrome and grade 2 or higher peripheral neuropathy are the principal exclusions. Adverse events (AEs) are graded by CTCAE v. 4.0. Objective disease status is evaluated according to RECIST 1.1. The primary objective of the phase (Ph) I portion of the study is to determine the maximum tolerated dose (MTD) of indibulin when given in dd fashion 5 days treatment, 9 days rest using standard 3+3 dose escalation schema.
The secondary objectives are to evaluate safety profile at various dosing levels, pharmacokinetics (PK) and preliminary activity of indibulin. Once the MTD is defined, a food effect cross- over group (N = 12) will be enrolled. Two groups of 6 pts each will be treated in either the fed or fasted state during the first cycle. A subgroup of 13 pts consisting of 12 pts from the food effect group plus the last pt from the MTD cohort will be evaluated for PFS at 4 months and will serve as the population for the first stage of a Simon two-stage design. If 4 or more out of 13 pts do not progress at 4 months, the Ph II portion of the study will be opened.
Results: Twenty one pts (20 F, 1 M) have been enrolled to cohorts 1 through 6 and the dose escalation is ongoing. Preliminary safety and efficacy data have been analyzed for 18 pts treated in cohorts 1 through 5 and are presented henceforth. No DLT has been observed and no MTD has been reached. Median age 58 years (32–81). PS 0=4, 1=12, 2=2. Median number of prior therapies 5 (1–12). Most frequent treatment-emergent AEs were: anorexia, constipation, cough, nausea (each in 39% pts); dyspnea (33%); fatigue, vomiting (each 28%). There were no related grade 3–4 AEs. PK analysis revealed that indibulin plasma exposures increased approximately dose proportionally from 25 to 200 mg with Cmax of 165 ± 89 ng/mL and AUC0-24 of 1411 ± 111 ng·h/mL at 200 mg. There were no objective responses. Stable disease was seen in 1 pt in the 150 mg cohort. Longest duration on-study was 4 months.
Conclusions: Oral indibulin was well tolerated in the doses up to 200 mg and the dose-proportional PK with lack of DLTs allows for further dose-escalation. Stable disease observed at sub-MTD dose may be a sign of activity in this heavily pre-treated population.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P6-11-10.
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Affiliation(s)
- TA Traina
- Memorial Sloan-Kettering Cancer Center, New York, NY; Evergreen Hematology and Oncology, Spokane, WA; Compass Oncology, Vancouver, WA; The West Clinic, Memphis, TN; US Oncology Research, Woodlands, TX; ZIOPHARM Oncology, Inc., Boston, MA; Harmon Hill Consulting, New York, NY
| | - C Hudis
- Memorial Sloan-Kettering Cancer Center, New York, NY; Evergreen Hematology and Oncology, Spokane, WA; Compass Oncology, Vancouver, WA; The West Clinic, Memphis, TN; US Oncology Research, Woodlands, TX; ZIOPHARM Oncology, Inc., Boston, MA; Harmon Hill Consulting, New York, NY
| | - A Seidman
- Memorial Sloan-Kettering Cancer Center, New York, NY; Evergreen Hematology and Oncology, Spokane, WA; Compass Oncology, Vancouver, WA; The West Clinic, Memphis, TN; US Oncology Research, Woodlands, TX; ZIOPHARM Oncology, Inc., Boston, MA; Harmon Hill Consulting, New York, NY
| | - D Gajria
- Memorial Sloan-Kettering Cancer Center, New York, NY; Evergreen Hematology and Oncology, Spokane, WA; Compass Oncology, Vancouver, WA; The West Clinic, Memphis, TN; US Oncology Research, Woodlands, TX; ZIOPHARM Oncology, Inc., Boston, MA; Harmon Hill Consulting, New York, NY
| | - J Gonzalez
- Memorial Sloan-Kettering Cancer Center, New York, NY; Evergreen Hematology and Oncology, Spokane, WA; Compass Oncology, Vancouver, WA; The West Clinic, Memphis, TN; US Oncology Research, Woodlands, TX; ZIOPHARM Oncology, Inc., Boston, MA; Harmon Hill Consulting, New York, NY
| | - SP Anthony
- Memorial Sloan-Kettering Cancer Center, New York, NY; Evergreen Hematology and Oncology, Spokane, WA; Compass Oncology, Vancouver, WA; The West Clinic, Memphis, TN; US Oncology Research, Woodlands, TX; ZIOPHARM Oncology, Inc., Boston, MA; Harmon Hill Consulting, New York, NY
| | - DA Smith
- Memorial Sloan-Kettering Cancer Center, New York, NY; Evergreen Hematology and Oncology, Spokane, WA; Compass Oncology, Vancouver, WA; The West Clinic, Memphis, TN; US Oncology Research, Woodlands, TX; ZIOPHARM Oncology, Inc., Boston, MA; Harmon Hill Consulting, New York, NY
| | - JC Chandler
- Memorial Sloan-Kettering Cancer Center, New York, NY; Evergreen Hematology and Oncology, Spokane, WA; Compass Oncology, Vancouver, WA; The West Clinic, Memphis, TN; US Oncology Research, Woodlands, TX; ZIOPHARM Oncology, Inc., Boston, MA; Harmon Hill Consulting, New York, NY
| | - J Jac
- Memorial Sloan-Kettering Cancer Center, New York, NY; Evergreen Hematology and Oncology, Spokane, WA; Compass Oncology, Vancouver, WA; The West Clinic, Memphis, TN; US Oncology Research, Woodlands, TX; ZIOPHARM Oncology, Inc., Boston, MA; Harmon Hill Consulting, New York, NY
| | - H Youssoufian
- Memorial Sloan-Kettering Cancer Center, New York, NY; Evergreen Hematology and Oncology, Spokane, WA; Compass Oncology, Vancouver, WA; The West Clinic, Memphis, TN; US Oncology Research, Woodlands, TX; ZIOPHARM Oncology, Inc., Boston, MA; Harmon Hill Consulting, New York, NY
| | - CC Korth
- Memorial Sloan-Kettering Cancer Center, New York, NY; Evergreen Hematology and Oncology, Spokane, WA; Compass Oncology, Vancouver, WA; The West Clinic, Memphis, TN; US Oncology Research, Woodlands, TX; ZIOPHARM Oncology, Inc., Boston, MA; Harmon Hill Consulting, New York, NY
| | - JA Barrett
- Memorial Sloan-Kettering Cancer Center, New York, NY; Evergreen Hematology and Oncology, Spokane, WA; Compass Oncology, Vancouver, WA; The West Clinic, Memphis, TN; US Oncology Research, Woodlands, TX; ZIOPHARM Oncology, Inc., Boston, MA; Harmon Hill Consulting, New York, NY
| | - L Sun
- Memorial Sloan-Kettering Cancer Center, New York, NY; Evergreen Hematology and Oncology, Spokane, WA; Compass Oncology, Vancouver, WA; The West Clinic, Memphis, TN; US Oncology Research, Woodlands, TX; ZIOPHARM Oncology, Inc., Boston, MA; Harmon Hill Consulting, New York, NY
| | - L Norton
- Memorial Sloan-Kettering Cancer Center, New York, NY; Evergreen Hematology and Oncology, Spokane, WA; Compass Oncology, Vancouver, WA; The West Clinic, Memphis, TN; US Oncology Research, Woodlands, TX; ZIOPHARM Oncology, Inc., Boston, MA; Harmon Hill Consulting, New York, NY
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Deukmedjian AR, Dakwar E, Ahmadian A, Smith DA, Uribe JS. Early outcomes of minimally invasive anterior longitudinal ligament release for correction of sagittal imbalance in patients with adult spinal deformity. ScientificWorldJournal 2012; 2012:789698. [PMID: 23304089 PMCID: PMC3523605 DOI: 10.1100/2012/789698] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2012] [Accepted: 10/21/2012] [Indexed: 11/17/2022] Open
Abstract
The object of this study was to evaluate a novel surgical technique in the treatment of adult degenerative scoliosis and present our early experience with the minimally invasive lateral approach for anterior longitudinal ligament release to provide lumbar lordosis and examine its impact on sagittal balance. Methods. All patients with adult spinal deformity (ASD) treated with the minimally invasive lateral retroperitoneal transpsoas interbody fusion (MIS LIF) for release of the anterior longitudinal ligament were examined. Patient demographics, clinical data, spinopelvic parameters, and outcome measures were recorded. Results. Seven patients underwent release of the anterior longitudinal ligament (ALR) to improve sagittal imbalance. All cases were split into anterior and posterior stages, with mean estimated blood loss of 125 cc and 530 cc, respectively. Average hospital stay was 8.3 days, and mean follow-up time was 9.1 months. Comparing pre- and postoperative 36'' standing X-rays, the authors discovered a mean increase in global lumbar lordosis of 24 degrees, increase in segmental lumbar lordosis of 17 degrees per level of ALL released, decrease in pelvic tilt of 7 degrees, and decrease in sagittal vertical axis of 4.9 cm. At the last followup, there was a mean improvement in VAS and ODI scores of 26.2% and 18.3%. Conclusions. In the authors' early experience, release of the anterior longitudinal ligament using the minimally invasive lateral retroperitoneal transpsoas approach may be a feasible alternative in correcting sagittal deformity.
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Affiliation(s)
- Armen R Deukmedjian
- Department of Neurosurgery and Brain Repair, University of South Florida, 2 Tampa General Circle, 7th Floor, Tampa, FL 33606, USA.
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Deukmedjian AR, Le TV, Baaj AA, Dakwar E, Smith DA, Uribe JS. Anterior longitudinal ligament release using the minimally invasive lateral retroperitoneal transpsoas approach: a cadaveric feasibility study and report of 4 clinical cases. J Neurosurg Spine 2012; 17:530-9. [DOI: 10.3171/2012.8.spine12432] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object
Traditional procedures for correction of sagittal imbalance via shortening of the posterior column include the Smith-Petersen osteotomy, pedicle subtraction osteotomy, and vertebral column resection. These procedures require wide exposure of the spinal column posteriorly, and may be associated with significant morbidity. Anterior longitudinal ligament (ALL) release using the minimally invasive lateral retroperitoneal approach with a resultant net lengthening of the anterior column has been performed as an alternative to increase lordosis. The objective of this study was to demonstrate the feasibility and early clinical experience of ALL release through a minimally invasive lateral retroperitoneal transpsoas approach, as well as to describe its surgical anatomy in the lumbar spine.
Methods
Forty-eight lumbar levels were dissected in 12 fresh-frozen cadaveric specimens to study the anatomy of the ALL as well as its surrounding structures, and to determine the feasibility of the technique. The lumbar disc spaces and ALL were accessed via the lateral transpsoas approach and confirmed with fluoroscopy in each specimen. As an adjunct, 4 clinical cases of ALL release through the minimally invasive lateral retroperitoneal transpsoas approach were reviewed. Operative technique, results, complications, and early outcomes were assessed.
Results
In the cadaveric study, sectioning of the ALL proved to be feasible from the minimally invasive lateral retroperitoneal transpsoas approach. The structures at most immediate risk during this procedure were the aorta, inferior vena cava, iliac vessels, and sympathetic plexus. The mean increase in segmental lumbar lordosis per level of ALL release was 10.2°, while global lumbar lordosis improved by 25°. Each level of ALL release took 56 minutes and produced 40 ml of blood loss on average. Visual analog scale and Oswestry Disability Index scores improved by 9 and 35 points, respectively. There were no cases of hardware failure, and as of yet no complications to report.
Conclusions
This initial experience suggests that ALL release through the minimally invasive lateral retroperitoneal transpsoas approach may be feasible, allows for improvement of lumbar lordosis without the need of an open laparotomy/thoracotomy, and minimizes the tissue disruption and morbidity associated with posterior osteotomies.
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Berhane Y, Smith DA, Newman S, Taylor M, Nagy E, Binnington B, Hunter B. Peripheral neuritis in psittacine birds with proventricular dilatation disease. Avian Pathol 2012; 30:563-70. [PMID: 19184947 DOI: 10.1080/03079450120078770] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Necropsies were performed on 14 psittacine birds of various species suspected to have proventricular dilatation disease (PDD). Eight of the birds exhibited neurological signs (seizures, ataxia, tremors and uncoordinated movements) and digestive tract signs (crop stasis, regurgitation, inappetance and presence of undigested food in the faeces). At necropsy, the birds had pectoral muscle atrophy, proventricular and ventricular distention, thinning of the gizzard wall, and duodenal dilation. In addition, five birds had a transparent fluid (0.2 to 1.0 ml) in the subarachnoidal space of the brain, and one bird had dilatation of the right ventricle of the heart. The histological lesions differed from earlier reports of PDD in that peripheral (sciatic, brachial and vagal) neuritis was seen in addition to myenteric ganglioneuritis, myocarditis, adrenalitis, myelitis and encephalitis.
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Uribe JS, Smith DA, Dakwar E, Baaj AA, Mundis GM, Turner AWL, Cornwall GB, Akbarnia BA. Lordosis restoration after anterior longitudinal ligament release and placement of lateral hyperlordotic interbody cages during the minimally invasive lateral transpsoas approach: a radiographic study in cadavers. J Neurosurg Spine 2012; 17:476-85. [PMID: 22938554 DOI: 10.3171/2012.8.spine111121] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECT In the surgical treatment of spinal deformities, the importance of restoring lumbar lordosis is well recognized. Smith-Petersen osteotomies (SPOs) yield approximately 10° of lordosis per level, whereas pedicle subtraction osteotomies result in as much as 30° increased lumbar lordosis. Recently, selective release of the anterior longitudinal ligament (ALL) and placement of lordotic interbody grafts using the minimally invasive lateral retroperitoneal transpsoas approach (XLIF) has been performed as an attempt to increase lumbar lordosis while avoiding the morbidity of osteotomy. The objective of the present study was to measure the effect of the selective release of the ALL and varying degrees of lordotic implants placed using the XLIF approach on segmental lumbar lordosis in cadaveric specimens between L-1 and L-5. METHODS Nine adult fresh-frozen cadaveric specimens were placed in the lateral decubitus position. Lateral radiographs were obtained at baseline and after 4 interventions at each level as follows: 1) placement of a standard 10° lordotic cage, 2) ALL release and placement of a 10° lordotic cage, 3) ALL release and placement of a 20° lordotic cage, and 4) ALL release and placement of a 30° lordotic cage. All four cages were implanted sequentially at each interbody level between L-1 and L-5. Before and after each intervention, segmental lumbar lordosis was measured in all specimens at each interbody level between L-1 and L-5 using the Cobb method on lateral radiography. RESULTS The mean baseline segmental lordotic angles at L1-2, L2-3, L3-4, and L4-5 were -3.8°, 3.8°, 7.8°, and 22.6°, respectively. The mean lumbar lordosis was 29.4°. Compared with baseline, the mean postimplantation increase in segmental lordosis in all levels combined was 0.9° in Intervention 1 (10° cage without ALL release); 4.1° in Intervention 2 (ALL release with 10° cage); 9.5° in Intervention 3 (ALL release with 20° cage); and 11.6° in Intervention 4 (ALL release with 30° cage). Foraminal height in the same sequence of conditions increased by 6.3%, 4.6%, 8.8% and 10.4%, respectively, while central disc height increased by 16.1%, 22.3%, 52.0% and 66.7%, respectively. Following ALL release and placement of lordotic cages at all 4 lumbar levels, the average global lumbar lordosis increase from preoperative lordosis was 3.2° using 10° cages, 12.0° using 20° cages, and 20.3° using 30° cages. Global lumbar lordosis with the cages at 4 levels exhibited a negative correlation with preoperative global lordosis (10°, R = -0.756; 20°, -0.730; and 30°, R = -0.437). CONCLUSIONS Combined ALL release and placement of increasingly lordotic lateral interbody cages leads to progressive gains in segmental lordosis in the lumbar spine. Mean global lumbar lordosis similarly increased with increasingly lordotic cages, although the effect with a single cage could not be evaluated. Greater global lordosis was achieved with smaller preoperative lordosis. The mean maximum increase in segmental lordosis of 11.6° followed ALL release and placement of the 30° cage.
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Affiliation(s)
- Juan S Uribe
- Department of Neurosurgery, University of South Florida, Tampa, Florida, USA
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Jellinger PS, Smith DA, Mehta AE, Ganda O, Handelsman Y, Rodbard HW, Shepherd MD, Seibel JA. American Association of Clinical Endocrinologists' Guidelines for Management of Dyslipidemia and Prevention of Atherosclerosis: executive summary. Endocr Pract 2012; 18:269-93. [PMID: 22507559 DOI: 10.4158/ep.18.2.269] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Jellinger PS, Smith DA, Mehta AE, Ganda O, Handelsman Y, Rodbard HW, Shepherd MD, Seibel JA. American Association of Clinical Endocrinologists' Guidelines for Management of Dyslipidemia and Prevention of Atherosclerosis. Endocr Pract 2012; 18 Suppl 1:1-78. [PMID: 22522068 DOI: 10.4158/ep.18.s1.1] [Citation(s) in RCA: 296] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Baaj AA, Dakwar E, Le TV, Smith DA, Ramos E, Smith WD, Uribe JS. Complications of the mini-open anterolateral approach to the thoracolumbar spine. J Clin Neurosci 2012; 19:1265-7. [PMID: 22766104 DOI: 10.1016/j.jocn.2012.01.026] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Revised: 01/27/2012] [Accepted: 01/29/2012] [Indexed: 10/28/2022]
Abstract
The mini-open anterolateral approach to the thoracolumbar spine is gaining popularity as a minimally-invasive alternative to traditional open thoracolumbar approaches. Published studies reporting and discussing the complications associated with this minimally invasive approach, however, are limited. We performed a retrospective review of patients undergoing the mini-open lateral approach to the thoracolumbar spine for corpectomy/fusion. Intraoperative and postoperative complications are reported and analyzed. Eighty consecutive patients underwent the mini-open lateral approach with corpectomy and fusion for trauma (71%), tumor (26%) and infection (3%). Total complication rate was 12.5% (dural tear 2.5%, intercostal neuralgia 2.5%, deep vein thrombosis 2.5%, pleural effusion 1.3%, wound infection 1.3%, hardware failure 1.3%, hemothorax 1.3%). Two patients needed a re-operation to address the complication (hardware failure, hemothorax). There were no postoperative neurological complications. The mini-open anterolateral approach to the thoracolumbar spine is an appealing alternative to the traditional open approaches. This technique, however, is technically demanding and requires proficiency in the use of minimally invasive spinal surgery instruments and retractors.
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Affiliation(s)
- Ali A Baaj
- Department of Neurological Surgery, 2A Columbia Drive, University of South Florida, Tampa, FL 33616, USA
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Baaj AA, Beckman J, Smith DA. O-Arm-based image guidance in minimally invasive spine surgery: technical note. Clin Neurol Neurosurg 2012; 115:342-5. [PMID: 22673041 DOI: 10.1016/j.clineuro.2012.05.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Revised: 04/30/2012] [Accepted: 05/12/2012] [Indexed: 11/26/2022]
Abstract
Three-dimensional (3D) image guidance technology is gaining popularity in spine surgery. The O-Arm navigation platform, which relies on cone-beam CT images acquired in the operative position, represents the most recent advancement in this field. We report our technique for MIS pedicle screw insertion using the O-Arm system and present two illustrative cases. We used percutaneous technique for short construct cases and "transfascial" technique for long-construct cases. O-Arm based navigation in minimally invasive spine surgery is safe and feasible. This technology may improve surgical accuracy and clinical outcomes but long term prospective studies are needed to validate this.
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Affiliation(s)
- Ali A Baaj
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA.
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Smith DA. ACP Journal Club. Adding niacin to simvastatin did not improve clinical outcomes in patients with CV disease and dyslipidemia. Ann Intern Med 2012; 156:JC4-08. [PMID: 22508748 DOI: 10.7326/0003-4819-156-8-201204170-02008] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Le TV, Smith DA, Greenberg MS, Dakwar E, Baaj AA, Uribe JS. Complications of lateral plating in the minimally invasive lateral transpsoas approach. J Neurosurg Spine 2012; 16:302-7. [DOI: 10.3171/2011.11.spine11653] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object
The aim of this study was to review the authors' experience with 101 cases over the past 3 years with minimally invasive lateral interbody fusion using a lateral plate. Their main goal was to specifically look for hardware-associated complications. Three cases of hardware failure and 3 cases of vertebral body (VB) fractures associated with lateral plate placement are reported. The authors also review the literature pertaining to lateral plates and related complications.
Methods
This study is a retrospective review of a database of patients who underwent minimally invasive lateral interbody fusion in the thoracolumbar spine during a 3-year period.
Results
Six complications were identified, resulting in an incidence of 5.9%. Three hardware failures, 2 coronal plane VB fractures, and 1 lateral VB fracture were identified. All complications occurred in multilevel cases. All cases presented with recurrent back pain except one, which was identified incidentally.
Conclusions
Minimally invasive lateral interbody fusion is a safe and direct technique that is practical, especially when trying to avoid other approaches for hardware insertion, and it also avoids the complications associated with other types of instrumentation such as pedicle screws. Careful consideration during patient selection and during the operation will aid in the avoidance of complications.
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Baaj AA, Smith DA, Vale FL, Uribe JS. Surgical approaches to thoracic ossification of the posterior longitudinal ligament. J Clin Neurosci 2012; 19:349-51. [PMID: 22249019 DOI: 10.1016/j.jocn.2011.05.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2011] [Revised: 05/12/2011] [Accepted: 05/14/2011] [Indexed: 10/14/2022]
Abstract
Thoracic ossification of the posterior longitudinal ligament is a rare but debilitating condition. It is most commonly diagnosed in the Japanese population. If left untreated, significant myelopathy and weakness can ensue. Anterior decompression and stabilization is effective but technically demanding and is associated with high rate of complications. Posterior laminectomy appears to be an acceptable approach with lower risks. This work reviews the published literature on this topic and highlights the salient points.
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Affiliation(s)
- Ali A Baaj
- Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, MD 21224, USA.
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Smith DA. ACP journal club. Meta-analysis: more intensive statin therapy prevents major vascular events. Ann Intern Med 2011; 154:JC5-03. [PMID: 21576521 DOI: 10.7326/0003-4819-154-10-201105170-02003] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Wang JJ, Kirkham J, Donegan J, Smith DA. High resolution imaging of actin filaments in living cells under physilogically relevant conditions using apertureless near-field microscopy. J Nanosci Nanotechnol 2010; 10:7489-7493. [PMID: 21137966 DOI: 10.1166/jnn.2010.2908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Living cells were used to demonstrate the potential biological applications of the apertureless SNOM when operating under fluid. An oral epithelial squamous cell carcinoma cell line (H357) was imaged under physiological-like conditions using apertureless SNOM following staining with FITC-Phalloidin which preferentially stains intracellular actin filaments of the cytoskeleton. Compared with simultaneously obtained AFM topographic image, the apertureless SNOM data provides greater detail on these cellular structures and the spatial resolution of the apertureless SNOM fluorescence image appears to be about 100 nm.
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Affiliation(s)
- J J Wang
- CRANN, Trinity College Dublin, Dublin 2, Ireland
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Simmons CR, Magee CL, Smith DA, Lauman L, Chaput JC, Allen JP. Three-dimensional structures reveal multiple ADP/ATP binding modes for a synthetic class of artificial proteins. Biochemistry 2010; 49:8689-99. [PMID: 20822107 DOI: 10.1021/bi100398p] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The creation of synthetic enzymes with predefined functions represents a major challenge in future synthetic biology applications. Here, we describe six structures of de novo proteins that have been determined using protein crystallography to address how simple enzymes perform catalysis. Three structures are of a protein, DX, selected for its stability and ability to tightly bind ATP. Despite the addition of ATP to the crystallization conditions, the presence of a bound but distorted ATP was found only under excess ATP conditions, with ADP being present under equimolar conditions or when crystallized for a prolonged period of time. A bound ADP cofactor was evident when Asp was substituted for Val at residue 65, but ATP in a linear configuration is present when Phe was substituted for Tyr at residue 43. These new structures complement previously determined structures of DX and the protein with the Phe 43 to Tyr substitution [Simmons, C. R., et al. (2009) ACS Chem. Biol. 4, 649-658] and together demonstrate the multiple ADP/ATP binding modes from which a model emerges in which the DX protein binds ATP in a configuration that represents a transitional state for the catalysis of ATP to ADP through a slow, metal-free reaction capable of multiple turnovers. This unusual observation suggests that design-free methods can be used to generate novel protein scaffolds that are tailor-made for catalysis.
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Affiliation(s)
- C R Simmons
- Center for Evolutionary Medicine and Informatics, The Biodesign Institute, Arizona State University, Tempe, Arizona 85287, USA
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Abdo AA, Ackermann M, Ajello M, Atwood WB, Baldini L, Ballet J, Barbiellini G, Bastieri D, Bechtol K, Bellazzini R, Berenji B, Blandford RD, Bloom ED, Bonamente E, Borgland AW, Bouvier A, Brandt TJ, Bregeon J, Brez A, Brigida M, Bruel P, Buehler R, Burnett TH, Buson S, Caliandro GA, Cameron RA, Caraveo PA, Carrigan S, Casandjian JM, Cecchi C, Celik O, Charles E, Chaty S, Chekhtman A, Cheung CC, Chiang J, Ciprini S, Claus R, Cohen-Tanugi J, Conrad J, Corbel S, Corbet R, DeCesar ME, den Hartog PR, Dermer CD, de Palma F, Digel SW, Donato D, do Couto e Silva E, Drell PS, Dubois R, Dubus G, Dumora D, Favuzzi C, Fegan SJ, Ferrara EC, Fortin P, Frailis M, Fuhrmann L, Fukazawa Y, Funk S, Fusco P, Gargano F, Gasparrini D, Gehrels N, Germani S, Giglietto N, Giordano F, Giroletti M, Glanzman T, Godfrey G, Grenier IA, Grondin MH, Grove JE, Guiriec S, Hadasch D, Harding AK, Hayashida M, Hays E, Healey SE, Hill AB, Horan D, Hughes RE, Itoh R, Jean P, Jóhannesson G, Johnson AS, Johnson RP, Johnson TJ, Johnson WN, Kamae T, Katagiri H, Kataoka J, Kerr M, Knödlseder J, Koerding E, Kuss M, Lande J, Latronico L, Lee SH, Lemoine-Goumard M, Garde ML, Longo F, Loparco F, Lott B, Lovellette MN, Lubrano P, Makeev A, Mazziotta MN, McConville W, McEnery JE, Mehault J, Michelson PF, Mizuno T, Moiseev AA, Monte C, Monzani ME, Morselli A, Moskalenko IV, Murgia S, Nakamori T, Naumann-Godo M, Nestoras I, Nolan PL, Norris JP, Nuss E, Ohno M, Ohsugi T, Okumura A, Omodei N, Orlando E, Ormes JF, Ozaki M, Paneque D, Panetta JH, Parent D, Pelassa V, Pepe M, Pesce-Rollins M, Piron F, Porter TA, Rainò S, Rando R, Ray PS, Razzano M, Razzaque S, Rea N, Reimer A, Reimer O, Reposeur T, Ripken J, Ritz S, Romani RW, Roth M, Sadrozinski HFW, Sander A, Parkinson PMS, Scargle JD, Schinzel FK, Sgrò C, Shaw MS, Siskind EJ, Smith DA, Smith PD, Sokolovsky KV, Spandre G, Spinelli P, Stawarz Ł, Strickman MS, Suson DJ, Takahashi H, Takahashi T, Tanaka T, Tanaka Y, Thayer JB, Thayer JG, Thompson DJ, Tibaldo L, Torres DF, Tosti G, Tramacere A, Uchiyama Y, Usher TL, Vandenbroucke J, Vasileiou V, Vilchez N, Vitale V, Waite AP, Wallace E, Wang P, Winer BL, Wolff MT, Wood KS, Yang Z, Ylinen T, Ziegler M, Maehara H, Nishiyama K, Kabashima F, Bach U, Bower GC, Falcone A, Forster JR, Henden A, Kawabata KS, Koubsky P, Mukai K, Nelson T, Oates SR, Sakimoto K, Sasada M, Shenavrin VI, Shore SN, Skinner GK, Sokoloski J, Stroh M, Tatarnikov AM, Uemura M, Wahlgren GM, Yamanaka M. Gamma-ray emission concurrent with the nova in the symbiotic binary V407 Cygni. Science 2010; 329:817-21. [PMID: 20705855 DOI: 10.1126/science.1192537] [Citation(s) in RCA: 146] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Novae are thermonuclear explosions on a white dwarf surface fueled by mass accreted from a companion star. Current physical models posit that shocked expanding gas from the nova shell can produce x-ray emission, but emission at higher energies has not been widely expected. Here, we report the Fermi Large Area Telescope detection of variable gamma-ray emission (0.1 to 10 billion electron volts) from the recently detected optical nova of the symbiotic star V407 Cygni. We propose that the material of the nova shell interacts with the dense ambient medium of the red giant primary and that particles can be accelerated effectively to produce pi(0) decay gamma-rays from proton-proton interactions. Emission involving inverse Compton scattering of the red giant radiation is also considered and is not ruled out.
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Affiliation(s)
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- Space Science Division, Naval Research Laboratory, Washington, DC 20375, USA
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Abdo AA, Ackermann M, Ajello M, Atwood WB, Baldini L, Ballet J, Barbiellini G, Bastieri D, Baughman BM, Bechtol K, Bellazzini R, Berenji B, Blandford RD, Bloom ED, Bonamente E, Borgland AW, Bregeon J, Brez A, Brigida M, Bruel P, Burnett TH, Buson S, Caliandro GA, Cameron RA, Caraveo PA, Casandjian JM, Cavazzuti E, Cecchi C, Celik O, Chekhtman A, Cheung CC, Chiang J, Ciprini S, Claus R, Cohen-Tanugi J, Colafrancesco S, Cominsky LR, Conrad J, Costamante L, Cutini S, Davis DS, Dermer CD, de Angelis A, de Palma F, Digel SW, do Couto e Silva E, Drell PS, Dubois R, Dumora D, Farnier C, Favuzzi C, Fegan SJ, Finke J, Focke WB, Fortin P, Fukazawa Y, Funk S, Fusco P, Gargano F, Gasparrini D, Gehrels N, Georganopoulos M, Germani S, Giebels B, Giglietto N, Giordano F, Giroletti M, Glanzman T, Godfrey G, Grenier IA, Grove JE, Guillemot L, Guiriec S, Hanabata Y, Harding AK, Hayashida M, Hays E, Hughes RE, Jackson MS, Jóhannesson G, Johnson AS, Johnson TJ, Johnson WN, Kamae T, Katagiri H, Kataoka J, Kawai N, Kerr M, Knödlseder J, Kocian ML, Kuss M, Lande J, Latronico L, Lemoine-Goumard M, Longo F, Loparco F, Lott B, Lovellette MN, Lubrano P, Madejski GM, Makeev A, Mazziotta MN, McConville W, McEnery JE, Meurer C, Michelson PF, Mitthumsiri W, Mizuno T, Moiseev AA, Monte C, Monzani ME, Morselli A, Moskalenko IV, Murgia S, Nolan PL, Norris JP, Nuss E, Ohsugi T, Omodei N, Orlando E, Ormes JF, Paneque D, Parent D, Pelassa V, Pepe M, Pesce-Rollins M, Piron F, Porter TA, Rainò S, Rando R, Razzano M, Razzaque S, Reimer A, Reimer O, Reposeur T, Ritz S, Rochester LS, Rodriguez AY, Romani RW, Roth M, Ryde F, Sadrozinski HFW, Sambruna R, Sanchez D, Sander A, Saz Parkinson PM, Scargle JD, Sgrò C, Siskind EJ, Smith DA, Smith PD, Spandre G, Spinelli P, Starck JL, Stawarz Ł, Strickman MS, Suson DJ, Tajima H, Takahashi H, Takahashi T, Tanaka T, Thayer JB, Thayer JG, Thompson DJ, Tibaldo L, Torres DF, Tosti G, Tramacere A, Uchiyama Y, Usher TL, Vasileiou V, Vilchez N, Vitale V, Waite AP, Wallace E, Wang P, Winer BL, Wood KS, Ylinen T, Ziegler M, Hardcastle MJ, Kazanas D. Fermi Gamma-Ray Imaging of a Radio Galaxy. Science 2010; 328:725-9. [PMID: 20360067 DOI: 10.1126/science.1184656] [Citation(s) in RCA: 175] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Abdo AA, Ackermann M, Ajello M, Atwood WB, Baldini L, Ballet J, Barbiellini G, Bastieri D, Baughman BM, Bechtol K, Bellazzini R, Berenji B, Blandford RD, Bloom ED, Bonamente E, Borgland AW, Bregeon J, Brez A, Brigida M, Bruel P, Burnett TH, Buson S, Caliandro GA, Cameron RA, Caraveo PA, Casandjian JM, Cavazzuti E, Cecchi C, Celik O, Charles E, Chekhtman A, Cheung CC, Chiang J, Ciprini S, Claus R, Cohen-Tanugi J, Cominsky LR, Conrad J, Cutini S, Dermer CD, de Angelis A, de Palma F, Digel SW, Di Bernardo G, do Couto e Silva E, Drell PS, Drlica-Wagner A, Dubois R, Dumora D, Farnier C, Favuzzi C, Fegan SJ, Focke WB, Fortin P, Frailis M, Fukazawa Y, Funk S, Fusco P, Gaggero D, Gargano F, Gasparrini D, Gehrels N, Germani S, Giebels B, Giglietto N, Giommi P, Giordano F, Glanzman T, Godfrey G, Grenier IA, Grondin MH, Grove JE, Guillemot L, Guiriec S, Gustafsson M, Hanabata Y, Harding AK, Hayashida M, Hughes RE, Itoh R, Jackson MS, Jóhannesson G, Johnson AS, Johnson RP, Johnson TJ, Johnson WN, Kamae T, Katagiri H, Kataoka J, Kawai N, Kerr M, Knödlseder J, Kocian ML, Kuehn F, Kuss M, Lande J, Latronico L, Lemoine-Goumard M, Longo F, Loparco F, Lott B, Lovellette MN, Lubrano P, Madejski GM, Makeev A, Mazziotta MN, McConville W, McEnery JE, Meurer C, Michelson PF, Mitthumsiri W, Mizuno T, Moiseev AA, Monte C, Monzani ME, Morselli A, Moskalenko IV, Murgia S, Nolan PL, Norris JP, Nuss E, Ohsugi T, Omodei N, Orlando E, Ormes JF, Paneque D, Panetta JH, Parent D, Pelassa V, Pepe M, Pesce-Rollins M, Piron F, Porter TA, Rainò S, Rando R, Razzano M, Reimer A, Reimer O, Reposeur T, Ritz S, Rochester LS, Rodriguez AY, Roth M, Ryde F, Sadrozinski HFW, Sanchez D, Sander A, Saz Parkinson PM, Scargle JD, Sellerholm A, Sgrò C, Shaw MS, Siskind EJ, Smith DA, Smith PD, Spandre G, Spinelli P, Starck JL, Strickman MS, Strong AW, Suson DJ, Tajima H, Takahashi H, Takahashi T, Tanaka T, Thayer JB, Thayer JG, Thompson DJ, Tibaldo L, Torres DF, Tosti G, Tramacere A, Uchiyama Y, Usher TL, Vasileiou V, Vilchez N, Vitale V, Waite AP, Wang P, Winer BL, Wood KS, Ylinen T, Ziegler M. Spectrum of the isotropic diffuse gamma-ray emission derived from first-year Fermi Large Area Telescope data. Phys Rev Lett 2010; 104:101101. [PMID: 20366411 DOI: 10.1103/physrevlett.104.101101] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Indexed: 05/29/2023]
Abstract
We report on the first Fermi Large Area Telescope (LAT) measurements of the so-called "extragalactic" diffuse gamma-ray emission (EGB). This component of the diffuse gamma-ray emission is generally considered to have an isotropic or nearly isotropic distribution on the sky with diverse contributions discussed in the literature. The derivation of the EGB is based on detailed modeling of the bright foreground diffuse Galactic gamma-ray emission, the detected LAT sources, and the solar gamma-ray emission. We find the spectrum of the EGB is consistent with a power law with a differential spectral index gamma = 2.41 +/- 0.05 and intensity I(>100 MeV) = (1.03 +/- 0.17) x 10(-5) cm(-2) s(-1) sr(-1), where the error is systematics dominated. Our EGB spectrum is featureless, less intense, and softer than that derived from EGRET data.
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Affiliation(s)
- A A Abdo
- Space Science Division, Naval Research Laboratory, Washington, D.C. 20375, USA
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Abdo AA, Ackermann M, Ajello M, Atwood WB, Baldini L, Ballet J, Barbiellini G, Bastieri D, Bechtol K, Bellazzini R, Berenji B, Bloom ED, Bonamente E, Borgland AW, Bouvier A, Bregeon J, Brez A, Brigida M, Bruel P, Burnett TH, Buson S, Caliandro GA, Cameron RA, Caraveo PA, Carrigan S, Casandjian JM, Cecchi C, Celik O, Chekhtman A, Chiang J, Ciprini S, Claus R, Cohen-Tanugi J, Conrad J, Dermer CD, de Angelis A, de Palma F, Digel SW, do Couto E Silva E, Drell PS, Drlica-Wagner A, Dubois R, Dumora D, Edmonds Y, Essig R, Farnier C, Favuzzi C, Fegan SJ, Focke WB, Fortin P, Frailis M, Fukazawa Y, Funk S, Fusco P, Gargano F, Gasparrini D, Gehrels N, Germani S, Giglietto N, Giordano F, Glanzman T, Godfrey G, Grenier IA, Grove JE, Guillemot L, Guiriec S, Gustafsson M, Hadasch D, Harding AK, Horan D, Hughes RE, Jackson MS, Jóhannesson G, Johnson AS, Johnson RP, Johnson WN, Kamae T, Katagiri H, Kataoka J, Kawai N, Kerr M, Knödlseder J, Kuss M, Lande J, Latronico L, Llena Garde M, Longo F, Loparco F, Lott B, Lovellette MN, Lubrano P, Makeev A, Mazziotta MN, McEnery JE, Meurer C, Michelson PF, Mitthumsiri W, Mizuno T, Moiseev AA, Monte C, Monzani ME, Morselli A, Moskalenko IV, Murgia S, Nolan PL, Norris JP, Nuss E, Ohsugi T, Omodei N, Orlando E, Ormes JF, Ozaki M, Paneque D, Panetta JH, Parent D, Pelassa V, Pepe M, Pesce-Rollins M, Piron F, Rainò S, Rando R, Razzano M, Reimer A, Reimer O, Reposeur T, Ripken J, Ritz S, Rodriguez AY, Roth M, Sadrozinski HFW, Sander A, Parkinson PMS, Scargle JD, Schalk TL, Sellerholm A, Sgrò C, Siskind EJ, Smith DA, Smith PD, Spandre G, Spinelli P, Starck JL, Strickman MS, Suson DJ, Tajima H, Takahashi H, Tanaka T, Thayer JB, Thayer JG, Tibaldo L, Torres DF, Uchiyama Y, Usher TL, Vasileiou V, Vilchez N, Vitale V, Waite AP, Wang P, Winer BL, Wood KS, Ylinen T, Ziegler M. Fermi large area telescope search for photon lines from 30 to 200 GeV and dark matter implications. Phys Rev Lett 2010; 104:091302. [PMID: 20366979 DOI: 10.1103/physrevlett.104.091302] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2009] [Indexed: 05/29/2023]
Abstract
Dark matter (DM) particle annihilation or decay can produce monochromatic gamma rays readily distinguishable from astrophysical sources. gamma-ray line limits from 30 to 200 GeV obtained from 11 months of Fermi Large Area Space Telescope data from 20-300 GeV are presented using a selection based on requirements for a gamma-ray line analysis, and integrated over most of the sky. We obtain gamma-ray line flux upper limits in the range 0.6-4.5x10{-9} cm{-2} s{-1}, and give corresponding DM annihilation cross-section and decay lifetime limits. Theoretical implications are briefly discussed.
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Affiliation(s)
- A A Abdo
- Space Science Division, Naval Research Laboratory, Washington, DC 20375, USA
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