Commentary: Lateral Thoracolumbar Listhesis as an Independent Predictor of Disability in Adult Scoliosis Patients: Multivariable Assessment Before and After Surgical Realignment

Abstract BACKGROUND Lateral (ie, coronal) vertebral listhesis may contribute to disability in adult scoliosis patients. OBJECTIVE To assess for a correlation between lateral listhesis and disability among patients with adult scoliosis. METHODS This was a retrospective multi-center analysis of prospectively collected data. Patients eligible for a minimum of 2-yr follow-up and with coronal plane deformity (defined as maximum Cobb angle ≥20º) were included (n = 724). Outcome measures were Oswestry Disability Index (ODI) and leg pain numeric scale rating. Lateral thoracolumbar listhesis was measured as the maximum vertebral listhesis as a percent of the superior endplate across T1-L5 levels. Linear and logistic regression was utilized, as appropriate. Multivariable analyses adjusted for demographics, comorbidities, surgical invasiveness, maximum Cobb angle, and T1-PA. Minimally clinically important difference (MCID) in ODI was defined as 12.8. RESULTS In total, 724 adult patients were assessed. The mean baseline maximum lateral thoracolumbar listhesis was 18.3% (standard deviation 9.7%). The optimal statistical grouping for lateral listhesis was empirically determined to be none/mild (<6.7%), moderate (6.7-15.4%), and severe (≥15.4%). In multivariable analysis, listhesis of moderate and severe vs none/mild was associated with worse baseline ODI (none/mild = 33.7; moderate = 41.6; severe = 43.9; P < .001 for both comparisons) and leg pain NSR (none/mild = 2.9, moderate = 4.0, severe = 5.1, P < .05). Resolution of severe lateral listhesis to none/mild was independently associated with increased likelihood of reaching MCID in ODI at 2 yr postoperatively (odds ratio 2.1 95% confidence interval 1.2–3.7, P = .0097). CONCLUSION Lateral thoracolumbar listhesis is associated with worse baseline disability among adult scoliosis patients. Resolution of severe lateral listhesis following deformity correction was independently associated with increased likelihood of reaching MCID in ODI at 2-yr follow-up.

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Abstract 4425: Baseline Aldosterone/Renin Ratios Predict Responses to Thiazide in Essential Hypertension, Particularly for Already-Treated Patients

Circulation ◽

10.1161/circ.118.suppl_18.s_887-a ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Huang Chin-Chou ◽

Leu Hsin-Bang ◽

Wu Tao-Cheng ◽

Lin Shing-Jong ◽

Chen Jaw-Wen

Keyword(s):

Blood Pressure ◽

Independent Predictor ◽

Current Treatment ◽

Renin Activity ◽

Diabetic Patients ◽

Antihypertensive Medications ◽

Hypertensive Patients ◽

Serum Aldosterone ◽

Before And After ◽

Untreated Hypertension

Background: Response to diuretics are variable among hypertensive patients. Our study sought to identify patients who respond well to thiazide diuretics. Methods: Non-diabetic patients with either treated or untreated hypertension were evaluated if their office systolic blood pressure was ≥ 140 mmHg or if their diastolic blood pressure was ≥ 90 mmHg. After 2 weeks of a controlled diet and life style modification, patients who still had an elevated blood pressure (BP) were prospectively given hydrochlorothiazide, 50 mg per day for 2 weeks, in addition to their current treatment if there was any. Variables monitored both before and after treatment included serum aldosterone and renin, office BP. Results: Sixty-six patients received 2 weeks of thiazide treatment. Of the 66, the 27 (41%) who had a significant reduction (≥ 10% reduction from baseline) in office mean arterial pressure (MAP) were defined as responders. The other 39 patients, those who had a reduction in office MAP of < 10% were defined as non-responders. Responders had a higher aldosterone/renin ratio (ARR) (77.90 ± 94.08 vs. 34.67 ± 45.56, p = 0.009) and a lower renin activity (7.44 ± 12.34 vs. 13.88 ± 14.00 pg/mL, p = 0.004). MAP reductions were directly correlated to ARR and inversely correlated to renin activity. ARR ≥ 18.58 independently predicted BP responses to thiazide in patients already taking other antihypertensive medications. Conclusions: The ARR is an independent predictor of responders to hydrochlorothiazide in non-diabetic hypertensive patients, particularly in those already taking other antihypertensive medications.

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Increase of the Adiponectin/Leptin Ratio in Patients with Obesity and Type 2 Diabetes after Roux-en-Y Gastric Bypass

Nutrients ◽

10.3390/nu11092069 ◽

2019 ◽

Vol 11 (9) ◽

pp. 2069 ◽

Cited By ~ 5

Author(s):

Xabier Unamuno ◽

Maitane Izaguirre ◽

Javier Gómez-Ambrosi ◽

Amaia Rodríguez ◽

Beatriz Ramírez ◽

...

Keyword(s):

Type 2 Diabetes ◽

Gastric Bypass ◽

Body Fat ◽

Independent Predictor ◽

Fat Percentage ◽

Sustained Weight Loss ◽

Before And After ◽

Effective Option ◽

Circulating Levels

Bariatric surgery remains the most effective option for achieving important and sustained weight loss. We explored the effects of Roux-en-Y gastric bypass (RYGB) on the circulating levels of adiponectin, leptin, and the adiponectin/leptin (Adpn/Lep) ratio in patients with obesity and type 2 diabetes (T2D). Twenty-five T2D volunteers undergoing RYGB were included in the study, and further subclassified as patients that responded or not to RYBG, regarding remission of T2D. Anthropometric and biochemical variables were evaluated before and after RYGB. Obese patients with T2D exhibited an increase (p < 0.0001) in the Adpn/Lep ratio after RYGB. Changes in the Adpn/Lep ratio correlated better with changes in anthropometric data (p < 0.001) than with the variations of adiponectin or leptin alone. Multiple regression analysis revealed that the change in the Adpn/Lep ratio in patients with T2D was an independent predictor of the changes in body mass index (p < 0.001) and body fat percentage (p = 0.022). However, the Adpn/Lep ratio did not differ between individuals with or without T2D remission after RYGB. In summary, the current study demonstrated that after weight and body fat loss following RYGB, the Adpn/Lep ratio increased in patients with obesity and T2D.

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THE IMPACT OF ANTI B-CELL THERAPY ON ARTERIAL STIFFNESS IN SYSTEMIC SCLERODERMA

Arterial’naya Gipertenziya (Arterial Hypertension) ◽

10.18705/1607-419x-2013-19-3-212-220 ◽

2013 ◽

Vol 19 (3) ◽

pp. 212-220 ◽

Cited By ~ 1

Author(s):

A. L. Maslyanskiy ◽

E. P. Kolesovа ◽

I. N. Penin ◽

M. D. Cheshuina ◽

S. V. Lapin ◽

...

Keyword(s):

Arterial Stiffness ◽

Immunosuppressive Therapy ◽

Arterial Wall ◽

Independent Predictor ◽

Vascular Wall ◽

Wall Stiffness ◽

Before And After ◽

Diffuse Form ◽

Design And Methods ◽

The Impact

Background.Arterial wall stiffness is an independent predictor of cardiovascular mortality in different patient populations. Currently, there are several studies that show an increase of arterial wall stiffness in systemic sclerosis (SSc). The effect of immunosuppressive therapy on vascular wall stiffness in SSc patients is not investigated. The authors of this paper attempted to study the effect of rituximab and cyclophosphamide combination therapy on vascular stiffness in 5 patients with diffuse form of SSc.Design and methods.We assessed arterial stiffness in 5 patients with diffuse form of SSc before and after 6 months after combined immunosuppressive therapy.Conclusion.The parameters of arterial stiffness decreased in all patients with the moderate effect of the therapy.

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Efficacy and safety of bridging thrombolysis initiated before transfer in a drip-and-ship stroke service

Stroke and Vascular Neurology ◽

10.1136/svn-2021-001024 ◽

2021 ◽

pp. svn-2021-001024

Author(s):

Jan Christoph Purrucker ◽

Miriam Heyse ◽

Simon Nagel ◽

Christoph Gumbinger ◽

Fatih Seker ◽

...

Keyword(s):

Endovascular Therapy ◽

Independent Predictor ◽

Intravenous Thrombolysis ◽

Efficacy And Safety ◽

Anterior Circulation ◽

Excellent Outcome ◽

Stroke Service ◽

Before And After ◽

Stroke Centre ◽

Strong Independent Predictor

ObjectiveData regarding the efficacy and safety of bridging thrombolysis (BT) initiated before transfer for evaluation of endovascular therapy is heterogeneous. We, therefore, analyse efficacy and safety of BT in patients treated within a drip-and-ship stroke service.MethodsConsecutive adult patients suffering from acute ischaemic stroke and large-vessel occlusions (LVO) transferred to our comprehensive stroke centre for evaluation of endovascular therapy in 2017–2020 were identified from a local prospective stroke database and categorised according to BT and no-BT. BT was defined as intravenous thrombolysis initiated before transfer. LVO was assessed before and after transfer. Functional outcome before stroke and at 3 months using the modified Rankin scale (mRS) was determined. Excellent outcome was defined as mRS 0–1 or return to prestroke mRS. For safety analysis, intracranial haemorrhages and mortality at 3 months were analysed. Main analysis was limited to patients with anterior circulation stroke.ResultsOf N=714 patients, n=394 (55.2%) received BT. More patients in the BT group with documented LVO before transfer recanalised without endovascular therapy (n=46, 11.7%) than patients who did not receive BT before transfer (n=4, 1.3%, p<0.001). In multivariate analysis, BT was the strongest independent predictor of early recanalisation (adjusted OR 10.9, 95% CI 3.8 to 31.1, p<0.001). BT tended to be an independent predictor of an excellent outcome at 3 months (adjusted OR 1.38, 95% CI 0.97 to 1.96, p=0.077). There were no differences in safety between the BT and no-BT groups.ConclusionsBT initiated before transfer was a strong independent predictor of early recanalisation.

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Hemispheric cerebral blood flow predicts outcome in acute small subcortical infarcts

Journal of Cerebral Blood Flow & Metabolism ◽

10.1177/0271678x211029884 ◽

2021 ◽

pp. 0271678X2110298

Author(s):

Lan Hong ◽

Yifeng Ling ◽

Ya Su ◽

Lumeng Yang ◽

Longting Lin ◽

...

Keyword(s):

Blood Flow ◽

Cerebral Blood Flow ◽

Clinical Outcome ◽

Clinical Outcomes ◽

Significant Interaction ◽

Independent Predictor ◽

Intravenous Thrombolysis ◽

Perfusion Ct ◽

Before And After

The association between baseline perfusion measures and clinical outcomes in patients with acute small subcortical infarcts (SSIs) has not been studied in detail. Post-processed acute perfusion CT and follow-up diffusion-weighted imaging of 71 patients with SSIs were accurately co-registered. Relative perfusion values were calculated from the perfusion values of the infarct lesion divided by those of the mirrored contralateral area. The association between perfusion measures with clinical outcomes and the interaction with intravenous thrombolysis were studied. Additionally, the perfusion measures for patients having perfusion CT before and after thrombolysis were compared. Higher contralateral hemispheric cerebral blood flow (CBF) was the only independent predictor of an excellent clinical outcome (modified Rankin Scale of 0-1) at 3 months (OR = 1.3, 95% CI 1.1–1.4, P = 0.001) amongst all the perfusion parameters, and had a significant interaction with thrombolysis (P = 0.04). Patients who had perfusion CT after thrombolysis demonstrated a better perfusion profile (relative CBF ≥1) than those who had perfusion CT before thrombolysis (After:45.5%, Before:21.1%, P = 0.03). This study implies that for patients with SSIs, hemispheric CBF is a predictor of clinical outcome and has an influence on the effect of intravenous thrombolysis.

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The surgeon’s impact on ER status.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.27_suppl.153 ◽

2012 ◽

Vol 30 (27_suppl) ◽

pp. 153-153

Author(s):

Kristin A. Skinner ◽

Rachel Leah Farkas ◽

Krisitn Mccarthy ◽

Ping Tang ◽

Leanne Hellman ◽

...

Keyword(s):

Multivariate Analysis ◽

Immunohistochemical Staining ◽

Independent Predictor ◽

False Negative ◽

Active Role ◽

Ischemic Time ◽

Breast Surgeon ◽

Before And After ◽

Type Of Surgery ◽

Er Status

153 Background: Long ischemic times prior to tissue fixation can lower the accuracy of immunohistochemical staining (IHC). The purpose of this study was to identify factors that impact the time to fixation (TTF), and to determine if TTF impacts prognostic factor (PF) patterns and if TTF can be changed with simple interventions. Methods: Surgeries performed between 2008 and June 2011 for which TTF was noted and PF testing was done were reviewed. TTF, patient age and race, surgeon, date and type of surgery, tumor size, nodal status, grade, and status of ER/PR and HER2 by IHC were noted. TTF was dichotomized into > or <60 minutes. In-Services (IS) for pathology and surgical staff were completed. TTF before and after the IS were compared. Associations between TTF and other factors were assessed using standard methods for contingency tables. Predictors of ER status were evaluated by multivariate analysis. Results: Mean TTF was 72 minutes (range 12-445) TTF was significantly associated with surgeon, type of specimen, and ER status (Table). TTF was an independent predictor of ER status by multivariate analysis. TTF was shorter and less variable after IS. Conclusions: TTF varied significantly between surgeons. IS training of the surgeons and OR and pathology staff can decrease TTF. Longer TTF was associated with increased ER negativity, suggesting that longer ischemic time interferes with IHC for ER. If prolonged TTF leads to false negative ER staining, patients may not receive optimal therapies. To minimize this risk, the breast surgeon should take an active role in minimizing the TTF. [Table: see text]

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Deformation Replication

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100068394 ◽

1970 ◽

Vol 28 ◽

pp. 280-281

Author(s):

J. Temple Black

Keyword(s):

Cutting Speed ◽

Machining Process ◽

Depth Of Cut ◽

Rake Face ◽

Orthogonal Machining ◽

Aluminum Chips ◽

Before And After ◽

Materials Used ◽

Glass Knife ◽

Very High

Tool materials used in ultramicrotomy are glass, developed by Latta and Hartmann (1) and diamond, introduced by Fernandez-Moran (2). While diamonds produce more good sections per knife edge than glass, they are expensive; require careful mounting and handling; and are time consuming to clean before and after usage, purchase from vendors (3-6 months waiting time), and regrind. Glass offers an easily accessible, inexpensive material ($0.04 per knife) with very high compressive strength (3) that can be employed in microtomy of metals (4) as well as biological materials. When the orthogonal machining process is being studied, glass offers additional advantages. Sections of metal or plastic can be dried down on the rake face, coated with Au-Pd, and examined directly in the SEM with no additional handling (5). Figure 1 shows aluminum chips microtomed with a 75° glass knife at a cutting speed of 1 mm/sec with a depth of cut of 1000 Å lying on the rake face of the knife.

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The Clinical, Roentgenological and Morphological Effects of an Acute Exposure of Phosgene on the Lungs of Dogs

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100065237 ◽

1971 ◽

Vol 29 ◽

pp. 236-237

Author(s):

R. F. Bils ◽

W. F. Diller ◽

F. Huth

Keyword(s):

Latent Period ◽

Chemical Industry ◽

Toxic Substance ◽

Lung Edema ◽

X Rays ◽

Beagle Dogs ◽

Male And Female ◽

Morphological Alterations ◽

Before And After ◽

Electron Microscopes

Phosgene still plays an important role as a toxic substance in the chemical industry. Thiess (1968) recently reported observations on numerous cases of phosgene poisoning. A serious difficulty in the clinical handling of phosgene poisoning cases is a relatively long latent period, up to 12 hours, with no obvious signs of severity. At about 12 hours heavy lung edema appears suddenly, however changes can be seen in routine X-rays taken after only a few hours' exposure (Diller et al., 1969). This study was undertaken to correlate these early changes seen by the roengenologist with morphological alterations in the lungs seen in the'light and electron microscopes.Forty-two adult male and female Beagle dogs were selected for these exposure experiments. Treated animals were exposed to 94.5-107-5 ppm phosgene for 10 min. in a 15 m3 chamber. Roentgenograms were made of the thorax of each animal before and after exposure, up to 24 hrs.

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Ultrastructure of Melanin Formation in Curvularia sp., Alternaria sp., and Drechslera Sorokiniana

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100079449 ◽

1977 ◽

Vol 35 ◽

pp. 398-399

Author(s):

M. H. Wheeler ◽

W. J. Tolmsoff ◽

A. A. Bell

Keyword(s):

Potassium Phosphate ◽

Thielaviopsis Basicola ◽

Wild Type ◽

Potassium Phosphate Buffer ◽

Transmission Microscopy ◽

Electron Transmission ◽

Melanin Formation ◽

Before And After ◽

Alternaria Sp ◽

Electron Transmission Microscopy

(+)-Scytalone [3,4-dihydro-3,6,8-trihydroxy-l-(2Hj-naphthalenone] and 1,8-di- hydroxynaphthalene (DHN) have been proposed as intermediates of melanin synthesis in the fungi Verticillium dahliae (1, 2, 3, 4) and Thielaviopsis basicola (4, 5). Scytalone is enzymatically dehydrated by V. dahliae to 1,3,8-trihydroxynaphthalene which is then reduced to (-)-vermelone [(-)-3,4- dihydro-3,8-dihydroxy-1(2H)-naphthalenone]. Vermelone is subsequently dehydrated to DHN which is enzymatically polymerized to melanin.Melanin formation in Curvularia sp., Alternaria sp., and Drechslera soro- kiniana was examined by light and electron-transmission microscopy. Wild-type isolates of each fungus were compared with albino mutants before and after treatment with 1 mM scytalone or 0.1 mM DHN in 50 mM potassium phosphate buffer, pH 7.0. Both chemicals were converted to dark pigments in the walls of hyphae and conidia of the albino mutants. The darkened cells were similar in appearance to corresponding cells of the wild types under the light microscope.

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