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David O Okonkwo - One of the best experts on this subject based on the ideXlab platform.
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low preoperative serum prealbumin levels and the postoperative surgical site infection risk in elective spine surgery a consecutive series
Journal of Neurosurgery, 2018Co-Authors: David J Salvetti, Zachary J Tempel, Ezequiel Goldschmidt, Nicole A Colwell, Federico Angriman, David M Panczykowski, Nitin Agarwal, Adam S Kanter, David O OkonkwoAbstract:OBJECTIVENutritional Deficiency negatively affects outcomes in many health conditions. In spine surgery, evidence linking preoperative Nutritional Deficiency to postoperative surgical site infection (SSI) has been limited to small retrospective studies. Authors of the current study analyzed a large consecutive cohort of patients who had undergone elective spine surgery to determine the relationship between a serum biomarker of Nutritional status (preoperative prealbumin levels) and SSI.METHODSThe authors conducted a retrospective review of the electronic medical charts of patients who had undergone posterior spinal surgeries and whose preoperative prealbumin level was available. Additional data pertinent to the risk of SSI were also collected. Patients who developed a postoperative SSI were identified, and risk factors for postoperative SSI were analyzed. Nutritional Deficiency was defined as a preoperative serum prealbumin level ≤ 20 mg/dl.RESULTSAmong a consecutive series of 387 patients who met the study criteria for inclusion, the infection rate for those with preoperative prealbumin ≤ 20 mg/dl was 17.8% (13/73), versus 4.8% (15/314) for those with preoperative prealbumin > 20 mg/dl. On univariate and multivariate analysis a low preoperative prealbumin level was a risk factor for postoperative SSI with a crude OR of 4.29 (p < 0.01) and an adjusted OR of 3.28 (p = 0.02). In addition, several previously known risk factors for infection, including diabetes, spinal fusion, and number of operative levels, were significant for the development of an SSI.CONCLUSIONSIn this consecutive series, preoperative prealbumin levels, a serum biomarker of Nutritional status, correlated with the risk of SSI in elective spine surgery. Prehabilitation before spine surgery, including strategies to improve Nutritional status in patients with Nutritional deficiencies, may increase value and improve spine care.
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preoperative prealbumin level as a risk factor for surgical site infection following elective spine surgery
Surgical Neurology International, 2015Co-Authors: David J Salvetti, Zachary J Tempel, Adam S Kanter, Gurpreet S Gandhoke, Philip V Parry, Ramesh Grandhi, David O OkonkwoAbstract:Background: Nutritional status is a critical factor in patient outcomes in a variety of medical contexts. In the surgical fields, there is substantial evidence suggesting that clinical outcomes including infection risk and surgical efficacy may be affected by preoperative Nutritional status. The purpose of this study is to evaluate preoperative serum prealbumin levels, the currently preferred serum biomarker of Nutritional Deficiency, in relation to the risk of developing a surgical site infection.
David J Salvetti - One of the best experts on this subject based on the ideXlab platform.
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low preoperative serum prealbumin levels and the postoperative surgical site infection risk in elective spine surgery a consecutive series
Journal of Neurosurgery, 2018Co-Authors: David J Salvetti, Zachary J Tempel, Ezequiel Goldschmidt, Nicole A Colwell, Federico Angriman, David M Panczykowski, Nitin Agarwal, Adam S Kanter, David O OkonkwoAbstract:OBJECTIVENutritional Deficiency negatively affects outcomes in many health conditions. In spine surgery, evidence linking preoperative Nutritional Deficiency to postoperative surgical site infection (SSI) has been limited to small retrospective studies. Authors of the current study analyzed a large consecutive cohort of patients who had undergone elective spine surgery to determine the relationship between a serum biomarker of Nutritional status (preoperative prealbumin levels) and SSI.METHODSThe authors conducted a retrospective review of the electronic medical charts of patients who had undergone posterior spinal surgeries and whose preoperative prealbumin level was available. Additional data pertinent to the risk of SSI were also collected. Patients who developed a postoperative SSI were identified, and risk factors for postoperative SSI were analyzed. Nutritional Deficiency was defined as a preoperative serum prealbumin level ≤ 20 mg/dl.RESULTSAmong a consecutive series of 387 patients who met the study criteria for inclusion, the infection rate for those with preoperative prealbumin ≤ 20 mg/dl was 17.8% (13/73), versus 4.8% (15/314) for those with preoperative prealbumin > 20 mg/dl. On univariate and multivariate analysis a low preoperative prealbumin level was a risk factor for postoperative SSI with a crude OR of 4.29 (p < 0.01) and an adjusted OR of 3.28 (p = 0.02). In addition, several previously known risk factors for infection, including diabetes, spinal fusion, and number of operative levels, were significant for the development of an SSI.CONCLUSIONSIn this consecutive series, preoperative prealbumin levels, a serum biomarker of Nutritional status, correlated with the risk of SSI in elective spine surgery. Prehabilitation before spine surgery, including strategies to improve Nutritional status in patients with Nutritional deficiencies, may increase value and improve spine care.
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preoperative prealbumin level as a risk factor for surgical site infection following elective spine surgery
Surgical Neurology International, 2015Co-Authors: David J Salvetti, Zachary J Tempel, Adam S Kanter, Gurpreet S Gandhoke, Philip V Parry, Ramesh Grandhi, David O OkonkwoAbstract:Background: Nutritional status is a critical factor in patient outcomes in a variety of medical contexts. In the surgical fields, there is substantial evidence suggesting that clinical outcomes including infection risk and surgical efficacy may be affected by preoperative Nutritional status. The purpose of this study is to evaluate preoperative serum prealbumin levels, the currently preferred serum biomarker of Nutritional Deficiency, in relation to the risk of developing a surgical site infection.
Marcia Martins Marques - One of the best experts on this subject based on the ideXlab platform.
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low intensity laser phototherapy enhances the proliferation of dental pulp stem cells under Nutritional Deficiency
Brazilian Oral Research, 2016Co-Authors: Cacio Mouranetto, Leila Soares Ferreira, Carlos Magno Da Costa Maranduba, Anna Carolina Volpi Mellomoura, Marcia Martins MarquesAbstract:Dental trauma in immature permanent teeth can damage pulp vascularization, which leads to necrosis and cessation of apexogenesis. Studies on tissue engineering using stem cells from human exfoliated deciduous teeth (SHEDs) have yielded promising results. Laser phototherapy (LPT) is able to influence the proliferation and differentiation of these cells, which could improve tissue engineering. SHEDs (eighth passage) were seeded into 96-well culture plates (103 cells/well) and were grown in culture medium supplemented with 15% defined fetal bovine serum (FBS) for 12 h. After determining the appropriate nutrition Deficiency status (5% FBS), the cells were assigned into four groups: 1) G1 – 15% FBS (positive control); 2) G2 – 5% FBS (negative control); 3) G3 – 5% FBS+LPT 3 J/cm2; and 4) G4 – 5% FBS+LPT 5 J/cm2. For the LPT groups, two laser irradiations at 6 h intervals were performed using a continuous wave InGaAlP diode laser (660 nm, with a spot size of 0.028 cm2, 10 mW) in punctual and contact mode. Cell viability was assessed via an MTT reduction assay immediately after the second laser irradiation (0 h) and 24, 48, and 72 h later. We found that G3 and G4 presented a significantly higher cell growth rate when compared with G2 (p 0.05). These findings indicate that LPT with 5 J/cm2 can enhance the growth of SHEDs during situations of Nutritional Deficiency. Therefore, LPT could be a valuable adjunct treatment in tissue engineering when using stem cells derived from the dental pulp of primary teeth.
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Low-intensity laser phototherapy enhances the proliferation of dental pulp stem cells under Nutritional Deficiency
Sociedade Brasileira de Pesquisa Odontológica, 2016Co-Authors: Cacio Moura Netto, Leila Soares Ferreira, Carlos Magno Maranduba, Anna Carolina Volpi Mello-moura, Marcia Martins MarquesAbstract:Abstract Dental trauma in immature permanent teeth can damage pulp vascularization, which leads to necrosis and cessation of apexogenesis. Studies on tissue engineering using stem cells from human exfoliated deciduous teeth (SHEDs) have yielded promising results. Laser phototherapy (LPT) is able to influence the proliferation and differentiation of these cells, which could improve tissue engineering. SHEDs (eighth passage) were seeded into 96-well culture plates (103 cells/well) and were grown in culture medium supplemented with 15% defined fetal bovine serum (FBS) for 12 h. After determining the appropriate nutrition Deficiency status (5% FBS), the cells were assigned into four groups: 1) G1 – 15% FBS (positive control); 2) G2 – 5% FBS (negative control); 3) G3 – 5% FBS+LPT 3 J/cm2; and 4) G4 – 5% FBS+LPT 5 J/cm2. For the LPT groups, two laser irradiations at 6 h intervals were performed using a continuous wave InGaAlP diode laser (660 nm, with a spot size of 0.028 cm2, 10 mW) in punctual and contact mode. Cell viability was assessed via an MTT reduction assay immediately after the second laser irradiation (0 h) and 24, 48, and 72 h later. We found that G3 and G4 presented a significantly higher cell growth rate when compared with G2 (p < 0.01). Moreover, G4 exhibited a similar cell growth rate as G1 throughout the entire experiment (p > 0.05). These findings indicate that LPT with 5 J/cm2 can enhance the growth of SHEDs during situations of Nutritional Deficiency. Therefore, LPT could be a valuable adjunct treatment in tissue engineering when using stem cells derived from the dental pulp of primary teeth
Jack M Gorman - One of the best experts on this subject based on the ideXlab platform.
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Schizoid personality disorder after prenatal exposure to famine.
American Journal of Psychiatry, 1996Co-Authors: Hans W Hoek, Buck Ka, L H Lumey, Lin Sp, Ezra Susser, Jack M GormanAbstract:Objective : The authors tested whether early prenatal exposure to famine was associated with schizophrenia spectrum personality disorder in addition to being associated with schizophrenia per se as shown in a previous study. Method : The risk of schizoid personality disorder, as defined by ICD-6 to ICD-9, in men at age 18 years was compared in birth cohorts that were conceived at the height of the Dutch Hunger Winter famine and in unexposed birth cohorts of 1944-1946 in the famine region of Holland. Results : The exposed cohort had a significantly greater risk (relative risk=2.01) of schizoid personality disorder. Conclusions : Prenatal Nutritional Deficiency was associated with a greater risk of schizoid personality disorder in men at age 18 years.
Hans W Hoek - One of the best experts on this subject based on the ideXlab platform.
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prenatal exposure to wartime famine and development of antisocial personality disorder in early adulthood
JAMA, 1999Co-Authors: Richard Neugebauer, Hans W Hoek, Ezra SusserAbstract:ContextSeveral observational epidemiological studies report an association of pregnancy and obstetric complications with development of antisocial personality disorder (ASPD) in offspring. However, the precise nature and timing of the hypothesized biological insults are not known.ObjectiveTo test whether severe maternal Nutritional Deficiency early in gestation is associated with risk for ASPD in offspring.Design and SettingRetrospective cohort study. From October 1944 to May 1945, the German army blockaded food supplies to the Netherlands, subjecting the western Netherlands first to moderate (official food rations, 4200-6300 kJ/d) then to severe (<4200 kJ/d) Nutritional Deficiency. The north and south were subjected to moderate Nutritional Deficiency only.ParticipantsDutch men born in large urban areas in 1944-1946 who were given psychiatric examinations for military induction at age 18 years (N=100,543) were classified by the degree and timing of their prenatal exposure to Nutritional Deficiency based on their birthdate and birthplace.Main Outcome MeasureDiagnosis of ASPD by psychiatric interview at time of medical examination for military induction, using the International Classification of Diseases, Sixth Revision (ICD-6).ResultsMen exposed prenatally to severe maternal Nutritional Deficiency during the first and/or second trimesters of pregnancy exhibited increased risk for ASPD (adjusted odds ratio [OR], 2.5; 95% confidence interval [CI], 1.5-4.2). Third-trimester exposure to severe Nutritional Deficiency and prenatal exposure to moderate Nutritional Deficiency were not associated with risk for ASPD.ConclusionsOur data suggest that severe Nutritional insults to the developing brain in utero may be capable of increasing the risk for antisocial behaviors in offspring. The possible implications of these findings for both developed countries and developing countries, where severe Nutritional Deficiency is widespread and often exacerbated by war, natural disaster, and forced migration, warrant study.
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Schizoid personality disorder after prenatal exposure to famine.
American Journal of Psychiatry, 1996Co-Authors: Hans W Hoek, Buck Ka, L H Lumey, Lin Sp, Ezra Susser, Jack M GormanAbstract:Objective : The authors tested whether early prenatal exposure to famine was associated with schizophrenia spectrum personality disorder in addition to being associated with schizophrenia per se as shown in a previous study. Method : The risk of schizoid personality disorder, as defined by ICD-6 to ICD-9, in men at age 18 years was compared in birth cohorts that were conceived at the height of the Dutch Hunger Winter famine and in unexposed birth cohorts of 1944-1946 in the famine region of Holland. Results : The exposed cohort had a significantly greater risk (relative risk=2.01) of schizoid personality disorder. Conclusions : Prenatal Nutritional Deficiency was associated with a greater risk of schizoid personality disorder in men at age 18 years.
