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Mount Sinai, NY, United States

Dizdarevic I.,Mount Sinai Roosevelt Hospital Center | Low S.,Thomas Jefferson University | Currie D.W.,University of Colorado at Denver | Comstock R.D.,University of Colorado at Denver | And 3 more authors.
American Journal of Sports Medicine | Year: 2016

Background: The elbow is the second most commonly dislocated major joint in the general population. Previous studies that focused on emergency department populations indicate that such injuries occur most frequently among adolescent athletes. Purpose: To describe the epidemiological rates and patterns of sports-related elbow dislocations in high school athletes. Study Design: Descriptive epidemiology study. Methods: Sports-related injury data for the 2005-2006 through 2013-2014 academic years from a national convenience sample of high schools participating in the National High School Sports-Related Injury Surveillance Study (High School Reporting Information Online [RIO]) were analyzed. Results: Certified athletic trainers participating in High School RIO reported 115 of 1246 (9.2%) elbow injuries as elbow dislocations. A total of 30,415,179 athlete exposures (AEs) were reported during the study period, resulting in a dislocation rate of 0.38 per 100,000 AEs. The majority of the dislocations resulted from boys' wrestling (46.1%) and football (37.4%). Elbow dislocation rates were higher in competition than in practice. Also, 91.3% of dislocations occurred in boys' sports. Among both boys (60.4%) and girls (88.9%), the majority of injuries occurred during varsity sports activities. Contact with another person was the most common injury mechanism (46.9%), followed by contact with the playing surface (46.0%). Dislocations more commonly resulted in removal from play for more than 3 weeks (23.4% vs 6.9%, respectively) or medical disqualification (36.9% vs 7.0%, respectively) compared with other elbow injuries. Dislocations were also more likely to result in surgical treatment than other elbow injuries (13.6% vs 4.7%, respectively). Conclusion: In high school athletes, elbow dislocations result in longer removal from play and are more likely to require surgical treatment than nondislocation-associated elbow injuries. Rates and patterns of elbow dislocations vary by sport. In high-risk sports, focused sport-specific prevention strategies may help to decrease the rates and severity of elbow dislocation injuries. © 2015 The Author(s.

Shantha Kumara H.M.C.,Mount Sinai Roosevelt Hospital Center | Kirchoff D.,Mount Sinai Roosevelt Hospital Center | Caballero O.L.,Ludwig Institute for Cancer Research | Caballero O.L.,Orygen Biotecnologia S.A. | And 11 more authors.
Oncoscience | Year: 2015

Introduction: IGF2BP3 (IMP3) is a mRNA binding protein that regulates IGF2 translation and function during embryogenesis. Because IGF2BP3 is undetectable in adult human tissues except the testis, and increased IGF2BP3 expression has been noted in several cancers, it is considered a cancer testis (CT) protein. IGF2BP3 mRNA expression in colorectal cancers (CRC) has not been well studied. This study's aim was to quantitatively assess IGF2BP3 mRNA expression in CRC and, thus, determine if IGF2BP3 has potential as a vaccine target. Method: Data were collected prospectively from CRC patients in an IRB-approved tissue and data bank. Total RNA was isolated and purified from tumor and normal colonic tissue samples and cDNA synthesized. IGF2BP3 expression was analyzed by quantitative PCR (QPCR). Expression levels of IGF2BP3 in tumors and testis were determined and compared. Tumors with levels greater than 0.1% or more of the testis levels were considered positive. Analysis of IGF2BP3 protein expression by immunohistochemistry (IHC) in tumor and normal tissues was also performed. Results: A total of 84 paired tumor and normal tissue specimens were assessed from patients with Stage 2 and 3 CRC; 43% of tumors had IGF2BP3 mRNA expression levels greater than 0.1 % of that of testis and were considered positive. The median tumor expression level was higher in women (p=0.042). No correlation was found between IGF2BP3 mRNA expression and tumor stage or lymph node involvement. IHC was carried out on paired tumor and normal tissue sections from 46 patients; IGF2BP3 staining was noted in 50% of the tumor sections and in 5% of the normal tissue sections. Discussion: IGF2BP3 mRNA was over expressed in 43% of the tumors whereas the protein was noted in 50% of samples. No correlation between mRNA expression and disease severity was noted. This protein holds promise as a vaccine target, however, a larger study that assesses a more diverse population of patients (Stage 1-4) as well as a study of preoperative serum samples for auto-antibodies to IGF2BP3 are needed to pursue this concept.

Miyagaki H.,Mount Sinai Roosevelt Hospital Center | Rhee R.,Mount Sinai Roosevelt Hospital Center | Shantha Kumara H.M.C.,Mount Sinai Roosevelt Hospital Center | Yan X.,Mount Sinai Roosevelt Hospital Center | And 4 more authors.
Surgical Innovation | Year: 2015

Introduction. Laparoscopic (LAP) colectomy is now the "gold" standard for diverticulitis; the role of hand-assisted LAP (HAL) and Open methods today is unclear. This study assessed the elective use of these methods for diverticulitis. Methods. A retrospective review of demographic, comorbidity (Carlson Comorbidity Index [CCI]), resection type, and short-term outcomes was carried out. Results. There were 125 (44.5%) LAP, 125 (44.5%) HAL, and 31 (11%) Open cases (overall N = 281). The mean age, body mass index, and percentage of high-risk patients (CCI score >2) of the HAL group were greater (P <.05) than the LAP group (vs Open, P = ns). The Open group's mean age and percent with CCI >2 was greater when compared with the LAP group (P <.05). More Open (P <.05) and HAL patients had complex disease (Open, 63%; HAL, 40%, LAP, 22%) and were diverted (Open, 35%; HAL, 10%; LAP, 3%). Time to bowel movement was not different; however, there was a stepwise increase in median length of stay (LOS; days) from the LAP (5 days) to HAL (6 days) to Open group (7 days) (P <.05 for all). The LAP complication rate (22.4%) was lower (P <.05) than the HAL (42.4%) or Open groups' (45.2%) rates. The LAP surgical site infection rate (5.6%) was lower (P <.05) than the HAL (12.8%) or Open groups (19.6%). Conclusion. The HAL and Open groups had more high risk, complex disease, diverted, and older patients than the LAP group; likewise, the overall complication rate and LOS was higher in the HAL and Open groups. Use of HAL methods likely contributed to the high minimally invasive surgery utilization rate (89%). © SAGE Publications.

Olivieri P.,Mount Sinai Roosevelt Hospital Center | Rose G.,Mount Sinai Roosevelt Hospital Center | Siadecki S.,Mount Sinai Roosevelt Hospital Center | Berkowitz R.,Mount Sinai Roosevelt Hospital Center | Saul T.,Mount Sinai Roosevelt Hospital Center
American Journal of Emergency Medicine | Year: 2015

Necrotizing fasciitis is a rare bacterial infection of the fascia and surrounding soft tissue, which carries a mortality rate as high as 20%, even in well-appearing patients [1]. Classically, this diagnosis must be made with computed tomography or magnetic resonance, but recent literature shows that ultrasonography, readily available in the emergency department, may be adequate for diagnosis [2]. We present a case of a 48-year-old man who presented with a painful rash. We used his clinical presentation and ultrasound to make the diagnosis,whichwas later corroborated with plain radiograph findings. Hewas taken immediately to the operating roomfor extensive debridement. He was discharged 8 days later in good condition.

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