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Manasa M, Galvin K, Fazl Alizadeh R, Ruhi-Williams P, Choi A, Samarasena J, Chang K, Nguyen NT. Correlation of the Endoscopic Gastroesophageal Flap Valve with Pathologic Reflux. J Am Coll Surg 2024; 238:1148-1152. [PMID: 38551241 DOI: 10.1097/xcs.0000000000001088] [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: 05/16/2024]
Abstract
BACKGROUND The Hill classification characterizes the geometry of gastroesophageal junction and Hill grades (HGs) III and IV have a high association with pathologic reflux. This study aimed to understand the use of the Hill classification and correlate the prevalence of pathologic reflux across different HGs. STUDY DESIGN A retrospective review of 477 patients who underwent upper endoscopy and BRAVO pH monitoring between August 2018 and October 2021 was performed. These charts were reviewed for endoscopic findings for hiatal hernia and association of HGs with pathologic reflux, defined as an abnormal esophageal acid exposure time (AET) of ≥4.9%. RESULTS Of 477 patients, 252 (52.8%) had an HG documented on the endoscopy report. Of the 252 patients, 61 had HG I (24.2%), 100 had HG II (39.7%), 61 had HG III (24.2%), and 30 had HG IV (11.9%). The proportion of patients with abnormal AET increases with increasing HGs (p < 0.001) as follows: I (39.3%), II (52.5%), III (67.2%), and IV (79.3%). The mean overall AET is as follows: HG I (5.5 ± 6%), HG II (7.0 ± 5.9%), HG III (10.2 ± 10.3%), and HG IV (9.5 ± 5.5%). The proportion of patients with hiatal hernia was 18% for HG I, 28% for HG II, 39.3% for HG III, and 80% for HG IV. CONCLUSIONS Use of the Hill classification in clinical practice is low. There is an association of increasing HGs with increasing proportion of patients with abnormal AET. There is a high proportion of patients within HGs I and II with documented pathologic reflux and the presence of a hiatal hernia as observed on endoscopic examination. Our study suggests that endoscopic grading of the gastroesophageal junction may not adequately differentiate between normal vs abnormal reflux status, particularly for HGs I and II.
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Affiliation(s)
- Morgan Manasa
- From the Department of Surgery, University of California, Irvine Medical Center, Orange, CA (Manasa, Galvin, Fazl Alizadeh, Ruhi-Williams, Nguyen)
| | - Katie Galvin
- From the Department of Surgery, University of California, Irvine Medical Center, Orange, CA (Manasa, Galvin, Fazl Alizadeh, Ruhi-Williams, Nguyen)
| | - Reza Fazl Alizadeh
- From the Department of Surgery, University of California, Irvine Medical Center, Orange, CA (Manasa, Galvin, Fazl Alizadeh, Ruhi-Williams, Nguyen)
| | - Perisa Ruhi-Williams
- From the Department of Surgery, University of California, Irvine Medical Center, Orange, CA (Manasa, Galvin, Fazl Alizadeh, Ruhi-Williams, Nguyen)
| | - Alyssa Choi
- Division of Gastroenterology, Digestive Health Institute, University of California, Irvine Medical Center, Orange, CA (Choi, Samarasena, Chang)
| | - Jason Samarasena
- Division of Gastroenterology, Digestive Health Institute, University of California, Irvine Medical Center, Orange, CA (Choi, Samarasena, Chang)
| | - Kenneth Chang
- Division of Gastroenterology, Digestive Health Institute, University of California, Irvine Medical Center, Orange, CA (Choi, Samarasena, Chang)
| | - Ninh T Nguyen
- From the Department of Surgery, University of California, Irvine Medical Center, Orange, CA (Manasa, Galvin, Fazl Alizadeh, Ruhi-Williams, Nguyen)
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Feather CB, Rehrig S, Allen R, Barth N, Kugler EM, Cullinane DC, Falank CR, Bhattacharya B, Maung AA, Seng S, Ratnasekera A, Bass GA, Butler D, Pascual JL, Srikureja D, Winicki N, Lynde J, Nowak B, Azar F, Thompson LA, Nahmias J, Manasa M, Tesoriero R, Kumar SB, Collom M, Kincaid M, Sperwer K, Santos AP, Klune JR, Turcotte J. To close or not to close? Wound management in emergent colorectal surgery, an EAST Multicenter prospective cohort study. J Trauma Acute Care Surg 2024:01586154-990000000-00677. [PMID: 38523130 DOI: 10.1097/ta.0000000000004321] [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: 03/26/2024]
Abstract
BACKGROUND To determine the clinical impact of wound management technique on surgical site infection (SSI), hospital length of stay (LOS) and mortality in emergent colorectal surgery. METHODS A prospective observational study (2021-2023) of urgent or emergent colorectal surgery patients at 15 institutions was conducted. Pediatric patients and traumatic colorectal injuries were excluded. Patients were classified by wound closure technique: skin closed (SC), skin loosely closed (SLC), or skin open (SO). Primary outcomes were SSI, hospital LOS and in-hospital mortality rates. Multivariable regression was used to assess the effect of wound closure on outcomes after controlling for demographics, patient characteristics, ICU admission, vasopressor use, procedure details and wound class. A priori power analysis indicated that 138 patients per group were required to detect a 10% difference in mortality rates. RESULTS In total, 557 patients were included (SC n = 262, SLC n = 124, SO n = 171). Statistically significant differences in BMI, race/ethnicity, ASA scores, EBL, ICU admission, vasopressor therapy, procedure details, and wound class were observed across groups (Table 1). Overall, average LOS was 16.9 ± 16.4 days, and rates of in-hospital mortality and SSI were 7.9% and 18.5%, respectively, with the lowest rates observed in the SC group (Table 2). After risk adjustment, SO was associated with increased risk of mortality (OR = 3.003, p = 0.028 in comparison to the SC group. SLC was associated with increased risk of superficial SSI (OR = 3.439, p = 0.014), after risk adjustment. CONCLUSION When compared to the SC group, the SO group was associated with mortality, but comparable when considering all other outcomes, while the SLC was associated with increased superficial SSI. Complete skin closure may be a viable wound management technique in emergent colorectal surgery. STUDY TYPE Level III Therapeutic/Care Management.
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Affiliation(s)
- Cristina B Feather
- Anne Arundel Medical Center and Doctors Community Medical Center, Luminis Health, Annapolis, MD
| | - Scott Rehrig
- Anne Arundel Medical Center and Doctors Community Medical Center, Luminis Health, Annapolis, MD
| | - Rebecca Allen
- Anne Arundel Medical Center and Doctors Community Medical Center, Luminis Health, Annapolis, MD
| | | | | | | | | | | | | | | | | | - Gary Alan Bass
- Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Dale Butler
- University of Texas Southwestern Medical Center, Dallas, TX
| | - Jose L Pascual
- Hospital of the University of Pennsylvania, Philadelphia, PA
| | | | - Nolan Winicki
- Loma Linda University Medical Center, Loma Linda, CA
| | - Jennifer Lynde
- Jackson Memorial Hospital, University of Miami, Miami, FL
| | - Brittany Nowak
- Jackson Memorial Hospital, University of Miami, Miami, FL
| | - Faris Azar
- St. Mary's Medical Center, Florida Atlantic University, West Palm Beach, FL
| | - Lauren A Thompson
- St. Mary's Medical Center, Florida Atlantic University, West Palm Beach, FL
| | | | - Morgan Manasa
- University of California at Irvine Health, Orange, CA
| | - Ronald Tesoriero
- Zuckerberg San Francisco General Hospital, UCSF, San Francisco, CA
| | - Sandhya B Kumar
- Zuckerberg San Francisco General Hospital, UCSF, San Francisco, CA
| | | | | | | | - Ariel P Santos
- Texas Tech University Health Science Center, Lubbock, TX
| | - J Robert Klune
- Anne Arundel Medical Center and Doctors Community Medical Center, Luminis Health, Annapolis, MD
| | - Justin Turcotte
- Anne Arundel Medical Center and Doctors Community Medical Center, Luminis Health, Annapolis, MD
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Manasa M, Yeates EO, Grigorian A, Barrios C, Schellenberg M, Owattanapanich N, Barmparas G, Margulies D, Juillard C, Garber K, Cryer H, Tillou A, Burruss S, Penaloza-Villalobos L, Lin A, Figueras RA, Coimbra R, Brenner M, Costantini T, Santorelli J, Curry T, Wintz D, Biffl WL, Schaffer KB, Duncan TK, Barbaro C, Diaz G, Johnson A, Tay-Lasso E, Chinn J, Naaseh A, Leung A, Grabar C, Nahmias J. The Effect of 2019 Coronavirus Stay-at-Home Order on Geriatric Trauma Patients in Southern California. Am Surg 2023; 89:6053-6059. [PMID: 37347234 DOI: 10.1177/00031348221124329] [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: 06/23/2023]
Abstract
BACKGROUND California issued stay-at-home (SAH) orders to mitigate COVID-19 spread. Previous studies demonstrated a shift in mechanisms of injuries (MOIs) and decreased length of stay (LOS) for the general trauma population after SAH orders. This study aimed to evaluate the effects of SAH orders on geriatric trauma patients (GTPs), hypothesizing decreased motor vehicle collisions (MVCs) and LOS. METHODS A post-hoc analysis of GTPs (≥65 years old) from 11 level-I/II trauma centers was performed, stratifying patients into 3 groups: before SAH (1/1/2020-3/18/2020) (PRE), after SAH (3/19/2020-6/30/2020) (POST), and a historical control (3/19/2019-6/30/2019) (CONTROL). Bivariate comparisons were performed. RESULTS 5486 GTPs were included (PRE-1756; POST-1706; CONTROL-2024). POST had a decreased rate of MVCs (7.6% vs 10.6%, P = .001; vs 11.9%, P < .001) and pedestrian struck (3.4% vs 5.8%, P = .001; vs 5.2%, P = .006) compared with PRE and CONTROL. Other mechanisms of injury, LOS, mortality, and operations performed were similar between cohorts. However, POST had a lower rate of discharge to skilled nursing facility (SNF) (20% vs 24.5%, P = .001; and 20% vs 24.4%, P = .001). CONCLUSION This retrospective multicenter study demonstrated lower rates of MVCs and pedestrian struck for GTPs, which may be explained by decreased population movement as a result of SAH orders. Contrary to previous studies on the generalized adult population, no differences in other MOIs and LOS were observed after SAH orders. However, there was a lower rate of discharge to SNF, which may be related to a lack of resources due to the COVID-19 pandemic, and thus potentially negatively impacted recovery of GTPs.Keywords.
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Affiliation(s)
- Morgan Manasa
- Department of Surgery, University of California, Irvine (UCI), Orange, CA, USA
| | - Eric O Yeates
- Department of Surgery, University of California, Irvine (UCI), Orange, CA, USA
| | - Areg Grigorian
- Department of Surgery, University of Southern California (USC), Los Angeles, CA, USA
| | - Cristobal Barrios
- Department of Surgery, University of California, Irvine (UCI), Orange, CA, USA
| | - Morgan Schellenberg
- Department of Surgery, University of Southern California (USC), Los Angeles, CA, USA
| | | | - Galinos Barmparas
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Daniel Margulies
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Catherine Juillard
- Department of Surgery, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Kent Garber
- Department of Surgery, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Henry Cryer
- Department of Surgery, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Areti Tillou
- Department of Surgery, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Sigrid Burruss
- Department of Surgery, Loma Linda University, Loma Linda, CA, USA
| | | | - Ann Lin
- Department of Surgery, Loma Linda University, Loma Linda, CA, USA
| | | | - Raul Coimbra
- Riverside University Health System, Moreno Valley, CA, USA
| | - Megan Brenner
- Riverside University Health System, Moreno Valley, CA, USA
| | - Todd Costantini
- Department of Surgery, University of California, San Diego (UCSD), San Diego, CA, USA
| | - Jarrett Santorelli
- Department of Surgery, University of California, San Diego (UCSD), San Diego, CA, USA
| | - Terry Curry
- Department of Surgery, University of California, San Diego (UCSD), San Diego, CA, USA
| | - Diane Wintz
- Department of Surgery, Sharp Memorial Hospital, San Diego, CA, USA
| | - Walter L Biffl
- Trauma Department, Scripps Memorial Hospital La Jolla, La Jolla, CA, USA
| | - Kathryn B Schaffer
- Trauma Department, Scripps Memorial Hospital La Jolla, La Jolla, CA, USA
| | - Thomas K Duncan
- Department of Surgery, Ventura County Medical Center, Ventura, CA, USA
| | - Casey Barbaro
- Department of Surgery, Ventura County Medical Center, Ventura, CA, USA
| | - Graal Diaz
- Department of Surgery, Ventura County Medical Center, Ventura, CA, USA
| | | | - Erika Tay-Lasso
- Department of Surgery, University of California, Irvine (UCI), Orange, CA, USA
| | - Justine Chinn
- Department of Surgery, University of California, Irvine (UCI), Orange, CA, USA
| | - Ariana Naaseh
- Department of Surgery, University of California, Irvine (UCI), Orange, CA, USA
| | - Amanda Leung
- Department of Surgery, University of California, Irvine (UCI), Orange, CA, USA
| | - Christina Grabar
- Department of Surgery, University of California, Irvine (UCI), Orange, CA, USA
| | - Jeffry Nahmias
- Department of Surgery, University of California, Irvine (UCI), Orange, CA, USA
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Ruhi-Williams P, Manasa M, Fazl Alizadeh R, Sullivan B, Kirby KA, Amin A, Nguyen NT. Impact of COVID-19 Pandemic on Management and Outcomes of Acute Cholecystitis at US Academic Centers. J Am Coll Surg 2023; 237:87-93. [PMID: 37318137 DOI: 10.1097/xcs.0000000000000668] [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: 03/02/2023]
Abstract
BACKGROUND The COVID-19 pandemic has had wide-ranging effects on management of medical conditions. Many hospitals encountered staffing shortages, limited operating room availability, and shortage of hospital beds. There was increased psychological stress and fear of contracting COVID-19 infection, leading to delay in medical care for various disease processes. The objective of this study was to examine changes in management and outcomes attributed to the COVID-19 pandemic in patients presenting with acute calculus cholecystitis at US academic centers. STUDY DESIGN Using the Vizient database, patients with the diagnosis of acute calculus cholecystitis who underwent intervention during the 15 months before the pandemic (prepandemic, October 2018 to December 2019) were compared with 15 months during the pandemic (pandemic, March 2020 to May 2021). Outcomes measures included demographics, characteristics, type of intervention, length of stay, in-hospital mortality, and direct cost. RESULTS There were 146,459 patients with acute calculus cholecystitis identified (prepandemic: 74,605 vs pandemic: 71,854). Patients in the pandemic group were more likely to undergo medical management (29.4% vs 31.8%; p < 0.001) or percutaneous cholecystostomy tube placement (21.5% vs 18%; p < 0.001) and less likely to undergo laparoscopic cholecystectomy (69.8% vs 73.0%; p < 0.001). Patients in the pandemic group who underwent procedural intervention had longer length of stay (6.5 days vs 5.9 days; p < 0.001), higher in-hospital death (3.1% vs 2.3%; p < 0.001), and higher cost ($14,609 vs $12,570; p < 0.001). CONCLUSIONS In this analysis of patients with acute calculus cholecystitis, there were distinct changes in the management and outcomes of patients due to the COVID-19 pandemic. Changes in the type of intervention and outcomes are likely related to delayed presentation with increases in the severity and complexity of the disease.
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Affiliation(s)
- Perisa Ruhi-Williams
- From the University of California Irvine Medical Center, Department of Surgery, Orange, CA (Ruhi-Williams, Manasa, Alizadeh, Sullivan, Nguyen)
| | - Morgan Manasa
- From the University of California Irvine Medical Center, Department of Surgery, Orange, CA (Ruhi-Williams, Manasa, Alizadeh, Sullivan, Nguyen)
| | - Reza Fazl Alizadeh
- From the University of California Irvine Medical Center, Department of Surgery, Orange, CA (Ruhi-Williams, Manasa, Alizadeh, Sullivan, Nguyen)
| | - Brittany Sullivan
- From the University of California Irvine Medical Center, Department of Surgery, Orange, CA (Ruhi-Williams, Manasa, Alizadeh, Sullivan, Nguyen)
| | - Katharine A Kirby
- University of California Irvine, Center for Statistical Consulting, Department of Statistics, Irvine, CA (Kirby)
| | - Alpesh Amin
- University of California Irvine Medical Center, Department of Medicine, Orange, CA (Amin)
| | - Ninh T Nguyen
- From the University of California Irvine Medical Center, Department of Surgery, Orange, CA (Ruhi-Williams, Manasa, Alizadeh, Sullivan, Nguyen)
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Khanna NS, Anitha J, Manasa M, Apoorva N, Paul A. A comparative study on peek (Smartphone based) Visual acuity test and LogMAR visual acuity test. TNOA J Ophthalmic Sci Res 2023. [DOI: 10.4103/tjosr.tjosr_66_22] [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: 03/22/2023] Open
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Sullivan BG, Al-Khouja F, Herre M, Manasa M, Kreger A, Escobar J, Dinicu A, Naaseh A, Dehkordi-Vakil F, Stamos M, Pigazzi A, Jafari MD. Assessment of Medical Industry Compensation to US Physicians by Gender. JAMA Surg 2022; 157:1017-1022. [PMID: 36169943 PMCID: PMC9520440 DOI: 10.1001/jamasurg.2022.4301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 03/30/2022] [Accepted: 06/18/2022] [Indexed: 12/14/2022]
Abstract
Importance It has been well established that female physicians earn less than their male counterparts in all specialties and ranks despite controlling for confounding variables. Objective To investigate payments made from highest-grossing medical industry companies to female and male physicians and to assess compensation and engagement disparities based on gender. Design, Setting, and Participants This retrospective, population-based cross-sectional study used data from the Open Payments database for the 5 female and 5 male physicians who received the most financial compensation from each of the 15 highest-grossing medical supply companies in the US from January 2013 to January 2019. Main Outcomes and Measures The primary outcome was total general payments received by female and male physicians from medical industry over time and across industries. The secondary outcome was trends in industry payment to female and male physicians from 2013 to 2019. Results Among the 1050 payments sampled, 1017 (96.9%) of the 5 highest earners were men and 33 (3.1%) were women. Female physicians were paid a mean (SD) of $41 320 ($88 695), and male physicians were paid a mean (SD) of $1 226 377 ($3 377 957) (P < .001). On multivariate analysis, male gender was significantly associated with higher payment after adjusting for rank, h-index, and specialty (mean [SD], $1 025 413 [$162 578]; P < .001). From 2013 to 2019, the payment gap between female and male physicians increased from $54 343 to $166 778 (P < .001). Conclusions and Relevance This study found that male physicians received significantly higher payments from the highest-grossing medical industry companies compared with female physicians. This disparity persisted across all medical specialties and academic ranks. The health care industry gender payment gap continued to increase from 2013 to 2019, with a wider compensation gap in 2019.
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Affiliation(s)
| | - Fares Al-Khouja
- Department of Surgery, University of California, Irvine, Orange
| | - Margaret Herre
- Department of Surgery, Weill Cornell Medicine, New York, New York
| | - Morgan Manasa
- Department of Surgery, University of California, Irvine, Orange
| | | | - Jessica Escobar
- Department of Surgery, University of California, Irvine, Orange
| | - Andreea Dinicu
- Department of Surgery, University of California, Irvine, Orange
| | - Ariana Naaseh
- Department of Surgery, University of California, Irvine, Orange
| | | | - Michael Stamos
- Department of Surgery, University of California, Irvine, Orange
| | - Alessio Pigazzi
- Department of Surgery, Weill Cornell Medicine, New York, New York
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Fazl Alizadeh R, Li S, Sullivan B, Manasa M, Ruhi-Williams P, Nahmias J, Carmichael J, Nguyen NT, Stamos MJ. Surgical Outcome in Laparoscopic Abdominal Surgical Operations with Clostridium Difficile Infection. Am Surg 2022; 88:2519-2524. [DOI: 10.1177/00031348221103644] [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
Introduction: Postoperative Clostridium difficile infection (CDI) has associated morbidity, but it is unknown how it impacts different operations. We sought to determine the incidence and postoperative morbidity following abdominal surgery. Method: The National Surgical Quality Improvement Program database (2015-2019) was utilized to evaluate adult (≥18 years-old) patients who developed CDI following laparoscopic abdominal operations. Univariate and multivariate analysis were performed to evaluate outcomes. Results: A total of 973 338 patients were studied and the overall incidence of CDI was .3% within 30 days of operation. Colorectal surgery had the highest incidence of CDI (1601/167 949,1.0%) with significantly longer mean length of stay (LOS) (8.0 days± 9.0, P < .01) compared to other surgical procedures. CDI patients also had a longer mean length of stay (6.6± 8.0 vs 2.1 ± 3.6 days, P < .01) and increased mortality (1.8% vs .2%, AOR: 4.64, CI: 3.45-5.67, P < .01) compared to patients without CDI. Conclusions: This national analysis demonstrates that CDI is a significant complication following abdominal surgery and is associated with increased LOS and mortality. Furthermore, laparoscopic colorectal surgery appears to have the greatest risk of CDI. Future research is needed to determine the exact cause in order to decrease the incidence of CDI by reconsidering the protocol of antibiotic use within the high-risk population.
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Affiliation(s)
- Reza Fazl Alizadeh
- Department of Surgery, School of Medicine, University of California, Irvine, CA, USA
| | - Shiri Li
- Department of Surgery, New York Presbyterian Hospital, Weill Cornell College of Medicine, New York, NY, USA
| | - Brittany Sullivan
- Department of Surgery, School of Medicine, University of California, Irvine, CA, USA
| | - Morgan Manasa
- Department of Surgery, School of Medicine, University of California, Irvine, CA, USA
| | - Perisa Ruhi-Williams
- Department of Surgery, School of Medicine, University of California, Irvine, CA, USA
| | - Jeffery Nahmias
- Department of Surgery, School of Medicine, University of California, Irvine, CA, USA
| | - Joseph Carmichael
- Department of Surgery, School of Medicine, University of California, Irvine, CA, USA
| | - Ninh T. Nguyen
- Department of Surgery, School of Medicine, University of California, Irvine, CA, USA
| | - Michael J. Stamos
- Department of Surgery, School of Medicine, University of California, Irvine, CA, USA
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8
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Forrester JD, Bukur M, Dvorak JE, Faliks B, Hindin D, Kartiko S, Kheirbek T, Lin L, Manasa M, Martin TJ, Miskimins R, Patel B, Pieracci FM, Ritter KA, Schubl SD, Tung J, Huston JM. Surgical Infection Society: Chest Wall Injury Society Recommendations for Antibiotic Use during Surgical Stabilization of Traumatic Rib or Sternal Fractures to Reduce Risk of Implant Infection. Surg Infect (Larchmt) 2022; 23:321-331. [PMID: 35522129 DOI: 10.1089/sur.2022.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background: Surgical stabilization of rib fractures is recommended in patients with flail chest or multiple displaced rib fractures with physiologic compromise. Surgical stabilization of rib fractures (SSRF) and surgical stabilization of sternal fractures (SSSF) involve open reduction and internal fixation of fractures with a plate construct to restore anatomic alignment. Most plate constructs are composed of titanium and presence of this foreign, non-absorbable material presents opportunity for implant infection. Although implant infection rates after SSRF and SSSF are low, they present a challenging clinical entity often requiring prolonged antibiotic therapy, debridement, and potentially implant removal. Methods: The Surgical Infection Society's Therapeutics and Guidelines Committee and Chest Wall Injury Society's Publication Committee convened to develop recommendations for antibiotic use during and after surgical stabilization of traumatic rib and sternal fractures. Clinical scenarios included patients with concomitant infectious processes (sepsis, pneumonia, empyema, cellulitis) or sources of contamination (open chest, gross contamination) incurred as a result of their trauma and present at the time of their surgical stabilization. PubMed, Embase, and Cochrane databases were searched for pertinent studies. Using a process of iterative consensus, all committee members voted to accept or reject each recommendation. Results: For patients undergoing SSRF or SSSF in the absence of pre-existing infectious process, there is insufficient evidence to suggest existing peri-operative guidelines or recommendations are inadequate. For patients undergoing SSRF or SSSF in the presence of sepsis, pneumonia, or an empyema, there is insufficient evidence to provide recommendations on duration and choice of antibiotic. This decision may be informed by existing guidelines for the concomitant infection. For patients undergoing SSRF or SSSF with an open or contaminated chest there is insufficient evidence to provide specific antibiotic recommendations. Conclusions: This guideline document summarizes the current Surgical Infection Society and Chest Wall Injury Society recommendations regarding antibiotic use during and after surgical stabilization of traumatic rib or sternal fractures. Limited evidence exists in the chest wall surgical stabilization literature and further studies should be performed to delineate risk of implant infection among patients undergoing SSSRF or SSSF with concomitant infectious processes.
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Affiliation(s)
- Joseph D Forrester
- Division of General Surgery, Department of Surgery, Stanford University, Stanford, California, USA
| | - Marko Bukur
- Division of Acute Care Surgery, Department of Surgery, NYU Grossman School of Medicine, New York, New York, USA
| | - Justin E Dvorak
- Division of Trauma, Department of Surgery, MetroHealth Medical Center, Cleveland, Ohio, USA
| | - Bradley Faliks
- Division of General Surgery, Department of Surgery, Stanford University, Stanford, California, USA
| | - David Hindin
- Division of General Surgery, Department of Surgery, Stanford University, Stanford, California, USA
| | - Susan Kartiko
- Center for Trauma and Critical Care, Department of Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Tareq Kheirbek
- Department of Surgery, Brown University, Warren Alpert Medical School, Providence, Rhode Island, USA
| | - Leo Lin
- Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Morgan Manasa
- Department of General Surgery, University of California, Irvine, Irvine, California, USA
| | - Thomas J Martin
- Department of Surgery, Brown University, Warren Alpert Medical School, Providence, Rhode Island, USA
| | - Richard Miskimins
- Division of Acute Care Surgery, Department of Surgery, University of New Mexico, Albuquerque, New Mexico, USA
| | - Bhavik Patel
- Gold Coast University Hospital, Southport, Queensland, Australia
| | - Fredric M Pieracci
- Department of Surgery, Denver Health Medical Center, Denver, Colorado, USA
| | - Kaitlin A Ritter
- Department of Surgery, Denver Health Medical Center, Denver, Colorado, USA
| | - Sebastian D Schubl
- Department of General Surgery, University of California, Irvine, Irvine, California, USA
| | - Jamie Tung
- Division of General Surgery, Department of Surgery, Stanford University, Stanford, California, USA
| | - Jared M Huston
- Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
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Ravinder P, Manasa M, Roopa D, Bukhari NA, Hatamleh AA, Khan MY, M. S. R, Hameeda B, El Enshasy HA, Hanapi SZ, Sayyed RZ. Biosurfactant producing multifarious Streptomyces puniceus RHPR9 of Coscinium fenestratum rhizosphere promotes plant growth in chilli. PLoS One 2022; 17:e0264975. [PMID: 35290374 PMCID: PMC8923452 DOI: 10.1371/journal.pone.0264975] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/19/2022] [Indexed: 12/29/2022] Open
Abstract
The present study involves isolation of Streptomyces spp. from rhizosphere of Coscinium fenestratum Gaertn, an endangered medicinal plant from Western Ghats of Karnataka, India. Four potential isolates were identified by 16S rRNA sequencing as Streptomyces sp. RHPR3, Streptomyces puniceus RHPR9, Streptomyces sp. RHPR14 and Streptomyces mediolani RHPR25. An enrichment culture method was used for the isolation of Streptomyces spp. for biosurfactant activity. Among four potential Streptomyces spp., S. puniceus RHPR9 showed highest Emulsification index (EI) (78±0.2%) and Emulsification assay (EA) (223±0.2 EU mL-1). Thin layer chromatography, Fourier transform infrared spectroscopy (FTIR) and mass spectrometric analysis revealed that as glycolipid. Further confirmed by presence of fatty acids like hexanoic acid methyl ester, decanoic acid by Gas chromatography mass spectroscopy (GC-MS) analysis. S. puniceus RHPR9 showed a significant IAA production (41μg mL-1), solubilized P (749.1 μg mL-1), growth promotion of chilli (Capsicum annuum L.) was evaluated using paper towel method and greenhouse conditions. S. puniceus RHPR9 showed a significant increase in seed vigor index (2047) and increase in plant biomass (65%) when compared to uninoculated control. To our knowledge, this is the first report on epiphytic S. puniceus RHPR9 isolated from an endangered medicinal plant C. fenestratum Gaertn, for biosurfactant production and plant growth promotion activities.
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Affiliation(s)
- Polapally Ravinder
- Department of Microbiology, University College of Science, Osmania University Hyderabad, Hyderabad, India
| | - M. Manasa
- Department of Microbiology, University College of Science, Osmania University Hyderabad, Hyderabad, India
| | - D. Roopa
- Department of Wildlife and Management, Kuvempu University Shankaraghatta, Karnataka, India
| | - Najat A. Bukhari
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Ashraf Atef Hatamleh
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | | | - Reddy M. S.
- Asian PGPR Society for Sustainable Agriculture, Auburn University, Auburn, Alabama, United States of America
| | - Bee Hameeda
- Department of Microbiology, University College of Science, Osmania University Hyderabad, Hyderabad, India
- * E-mail: ,
| | - Hesham Ali El Enshasy
- Institute of Bioproduct Development (IBD), Universiti Teknologi Malaysia (UTM), Skudai, Johor, Malaysia
- School of Chemical and Energy Engineering, Faculty of Engineering, Universiti Teknologi Malaysia (UTM), Skudai, Johor, Malaysia
- City of Scientific Research and Technology Applications (SRTA), New Burg Al Arab, Alexandria, Egypt
| | - Siti Zulaiha Hanapi
- Institute of Bioproduct Development (IBD), Universiti Teknologi Malaysia (UTM), Skudai, Johor, Malaysia
| | - R. Z. Sayyed
- Department of Microbiology, PSGVP Mandal’s, S I Patil Arts, G B Patel Science & STKVS Commerce College, Shahada, India
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Manasa M, Chandewar PR, Mahalingam H. Photocatalytic degradation of ciprofloxacin & norfloxacin and disinfection studies under solar light using boron & cerium doped TiO2 catalysts synthesized by green EDTA-citrate method. Catal Today 2021. [DOI: 10.1016/j.cattod.2020.03.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Manasa M, Vani R. Evaluation of Caripill™ as a component of platelet storage solution. Hematol Transfus Cell Ther 2020; 43:133-140. [PMID: 32199922 PMCID: PMC8211629 DOI: 10.1016/j.htct.2020.01.003] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 12/01/2019] [Accepted: 01/02/2020] [Indexed: 01/24/2023] Open
Abstract
Background Carica papaya Linn. has high nutraceutical and pharmacological values. The leaves possess antimicrobial, anti-tumor and antioxidant properties. They are used to treat thrombocytopenia during dengue fever and the leaf extract is commercially available as tablets under the name Caripill™ (MicroLabs, Bengaluru). Nevertheless, platelet transfusion is recommended in severe cases of thrombocytopenia, but the platelet storage is limited to 5–7 days at 22−24 °C. Reducing oxidative stress (OS) during platelet storage might help in prolonging the shelf-life, since the OS is known to cause platelet storage lesion. Hence, this study investigated the effects of Caripill™ as an additive in Tyrode’s buffer during extended platelet storage. Methods Platelets isolated from 4 months old male Wistar rats were stored with Caripill™ (50 and 100 μg/ml) at 22 °C for 12 days. Platelet functional and metabolic markers and various OS markers were analyzed on days 0, 4, 8 and 12. Results Caripill™ (50 and 100 μg/ml) maintained platelet functions and lactate dehydrogenase, elevated nitrites, reduced glucose consumption, protected proteins and up-regulated the antioxidant enzymes. However, the CP100 up-regulated catalase from day 4, elevated nitrites from day 8, prevented the formation of secondary products of lipid peroxidation and increased the total antioxidant capacity on day 4. Conclusions Caripill™ reduced platelet storage lesion up to day 8 of storage. Results suggest that a higher concentration of Caripill™ was more effective in combating the oxidative damage during platelet storage. This study throws light on the beneficial effects of Caripill™ in combating oxidative stress during platelet storage.
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Affiliation(s)
- M Manasa
- JAIN (Deemed-to-be University), School of Sciences, Bangalore, India
| | - R Vani
- JAIN (Deemed-to-be University), School of Sciences, Bangalore, India.
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Manasa M, Revathi P, Chand MP, Maroudam V, Navaneetha P, Raj GD, Kishor PK, De B, Rathnagiri P. Protein-G-based lateral flow assay for rapid serodiagnosis of brucellosis in domesticated animals. J Immunoassay Immunochem 2018; 40:149-158. [DOI: 10.1080/15321819.2018.1541803] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- M. Manasa
- Department of Medical Microbiology, Genomix Molecular Diagnostics Pvt. Ltd, Hyderabad, India
| | - P. Revathi
- Department of Medical Microbiology, Genomix Molecular Diagnostics Pvt. Ltd, Hyderabad, India
| | - M. Prudhvi Chand
- Department of Medical Microbiology, Genomix Molecular Diagnostics Pvt. Ltd, Hyderabad, India
| | - V. Maroudam
- Translational Research Platform for Veterinary Biologicals, TANUVAS, Chennai, India
| | - P. Navaneetha
- Department of Medical Microbiology, Genomix Molecular Diagnostics Pvt. Ltd, Hyderabad, India
| | - G. Dhinakar Raj
- Translational Research Platform for Veterinary Biologicals, TANUVAS, Chennai, India
| | - P.B. Kavi Kishor
- Department of Medical Microbiology, Genomix Molecular Diagnostics Pvt. Ltd, Hyderabad, India
| | - B. De
- Department of Veterinary Microbiology, Genomix Biotech Inc, Atlanta, GA, USA
| | - P. Rathnagiri
- Department of Medical Microbiology, Genomix Molecular Diagnostics Pvt. Ltd, Hyderabad, India
- Department of Veterinary Microbiology, Genomix Biotech Inc, Atlanta, GA, USA
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Kambar Y, Vivek MN, Manasa M, Prashith Kekuda TR, Onkarappa R. Antimicrobial Activity of Ramalina conduplicans Vain. (Ramalinaceae). ACTA ACUST UNITED AC 2014. [DOI: 10.4314/star.v3i3.10] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Yashoda K, Manasa M, Vivek MN, Prashith Kekuda TR. Inhibitory Effect of Some Plants of Western Ghats of Karnataka against Colletotrichum capsici. ACTA ACUST UNITED AC 2014. [DOI: 10.4314/star.v3i2.10] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kambar Y, Vivek MN, Manasa M, Prashith KTR, Noor NAS. Inhibitory Effect of Cow Urine against Colletotrichum capsici Isolated from Anthracnose of Chilli ( Capsicum annuum L.). ACTA ACUST UNITED AC 2014. [DOI: 10.4314/star.v2i4.15] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Prashith KTR, Manasa M, Poornima G, Abhipsa V, Rekha C, Upashe SP, Raghavendra HL. Antibacterial, Cytotoxic and Antioxidant Potential of Vitex Negundo Var. Negundo and Vitex Negundo Var. Purpurascens – A Comparative Study. ACTA ACUST UNITED AC 2013. [DOI: 10.4314/star.v2i3.98737] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Poornima G, Manasa M, Rudrappa D, Prashith KTR. Medicinal Plants Used by Herbal Healers in Narasipura and Manchale Villages of Sagara Taluk, Karnataka, India. ACTA ACUST UNITED AC 2013. [DOI: 10.4314/star.v1i2.98779] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kinney EL, Manasa M, Kessler KM, Matzer L, Cortada X, Zakharia A, Myerburg RJ, Chahine RA. Two-dimensional echocardiographic appearance of pseudo-dehiscence of Hancock aortic prosthesis. Am Heart J 1985; 109:169-71. [PMID: 3966320 DOI: 10.1016/0002-8703(85)90434-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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: 01/08/2023]
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