Baker M.S.,NorthShore University |
Bentrem D.J.,Jesse Brown Medical Center |
Ujiki M.B.,NorthShore University |
Stocker S.,NorthShore University |
Talamonti M.S.,NorthShore University
American Journal of Surgery | Year: 2011
Background Published comparisons of laparoscopic (laparoscopic distal pancreatectomy [LDP]) to open distal pancreatectomy (ODP) identify improved lengths of stay (LOS) after LDP but do not include data on readmissions. Methods Demographic, operative, and postoperative outcomes data for patients undergoing LDP or ODP between August 2007 and December 2009 were culled from our prospectively accruing pancreatic database. Electronic medical records were reviewed to determine cause, treatment, and LOS for readmissions. Results Patients undergoing LDP were statistically identical to those undergoing ODP in regard to age, presentation, demographic characteristics, comorbidities, operative times, tumor sizes, morbidity, mortality, and pancreatic fistula rates. The initial LOS was statistically shorter for those undergoing LDP (4.8 ± .1 days vs 8.7 ± .1 days, P < .001). The readmission rate for LDP was statistically higher than for ODP (25% vs 8%, P < .05). Overall LOS for LDP was 7.2 ± .3 days versus 9.3 ± .1 days for ODP (P = .2). Conclusions Adding readmission LOS to initial LOS eliminates the perceived effect of LDP to accelerate recovery. © 2011 Elsevier Inc.
PubMed | Inflammatory Bowel Disease Center and, Northwestern University, Section of Gastroenterology, University of Chicago and Northshore University
Type: Journal Article | Journal: The American journal of clinical nutrition | Year: 2016
Vitamin D exerts anti-inflammatory actions both in vitro and in murine models of colitis. In previous studies, we demonstrated that vitamin D protects against the development of colitis by maintaining the integrity of the intestinal mucosal barrier.We sought to evaluate whether deficient serum 25 hydroxyvitamin D [25(OH)D] concentrations are associated with increased mucosal inflammation, a loss of epithelial junctional proteins, and an increase in mucosal inflammatory cytokines in patients with ulcerative colitis (UC).We prospectively enrolled 230 subjects with UC. Serum 25(OH)D concentrations were compared with the Mayo endoscopic score, the total Mayo score, and histologic activity. Colonic mucosal expression concentrations of vitamin D receptor (VDR), E-cadherin, zonula occluden 1 (ZO-1), occludin, claudin-2, tumor necrosis factor (TNF-), and interleukin 8 (IL-8) were compared between dichotomous groups with low or high serum 25(OH)D concentrations.The mean serum 25(OH)D concentration was 21.8 ng/mL. Subjects stratified by concentrations included 12.6% 30 ng/mL, 45.6% 20 to <30 ng/mL, 37.4% 10 to <20 ng/mL, and 4.4% <10 ng/mL. There was an inverse association between serum 25(OH)D concentrations and mucosal inflammation as assessed by the Mayo endoscopy score (P = 0.01), disease activity as indicated by the total Mayo score (P = 0.001), and histologic activity (P = 0.02). A serum 25(OH)D concentration <20 ng/mL was associated with decreased mucosal transcript and protein expression concentrations of VDR, E-cadherin, and occludin as well as decreased protein expression of ZO-1, whereas TNF- and IL-8 mucosal transcript expression concentrations were increased.In UC patients, serum 25(OH)D concentration is inversely correlated with mucosal inflammation and disease activity. These results, coupled with the findings that serum 25(OH)D concentrations correlate with the mucosal expression of VDR as well as epithelial junction proteins and inversely with proinflammatory cytokines, suggest that vitamin D deficiency may contribute to UC inflammation by disrupting epithelial barrier function.
Howe L.L.S.,VA Palo Alto Health Care System |
Sweet J.J.,NorthShore University |
Sweet J.J.,University of Chicago |
Bauer R.M.,University of Florida
Clinical Neuropsychologist | Year: 2010
There are critical issues facing the neuropsychological community, such as inadequate reimbursement for services, a lack of familiarity among public policy makers regarding the science and practice of neuropsychology, and a lack of public policy awareness among professional neuropsychologists. Advocacy for the field is the most effective way to undertake positive change. Currently, a minority of psychological professionals actively engages in an advocacy process, while the majority is not involved, or is involved periodically or passively. With weak advocacy our field risks slower development in key areas, and without strong and constant advocacy we risk losing ground previously gained. The purpose of this article, and those that follow in this special issue of The Clinical Neuropsychologist, is to: (1) convey the importance of advocacy, (2) address and dispel unfounded mental obstacles that inhibit involvement in advocating for the specialty, and (3) aid neuropsychologists in preparing to join the advocacy process. To accomplish this, we acquaint readers with the advocacy process, delineate to practitioners how they can become involved, and encourage participation in advocacy. © 2010 Psychology Press.
Tu C.,University of Nebraska Medical Center |
Ortega-Cava C.F.,University of Nebraska Medical Center |
Winograd P.,University of Wisconsin - Madison |
Stanton M.J.,University of Nebraska Medical Center |
And 9 more authors.
Proceedings of the National Academy of Sciences of the United States of America | Year: 2010
Active Src localization at focal adhesions (FAs) is essential for cell migration. How this pool is linked mechanistically to the large pool of Src at late endosomes (LEs)/lysosomes (LY) is not well understood. Here, we used inducible Tsg101 gene deletion, TSG101 knockdown, and dominant-negative VPS4 expression to demonstrate that the localization of activated cellular Src and viral Src at FAs requires the endosomal-sorting complexes required for transport (ESCRT) pathway. Tsg101 deletion also led to impaired Src-dependent activation of STAT3 and focal adhesion kinase and reduced cell migration. Impairment of the ESCRT pathway or Rab7 function led to the accumulation of active Src at aberrant LE/LY compartments followed by its loss. Analyses using fluorescence recovery after photo-bleaching show that dynamic mobility of Src in endosomes is ESCRT pathway-dependent. These results reveal a critical role for an ESCRT pathway-dependent LE/LY trafficking step in Src function by promoting localization of active Src to FAs.
Lee Y.S.,USA Mobility |
Chaysinh S.,USA Mobility |
Garfield C.,NorthShore University |
Hassan S.,USA Mobility |
Noel M.,Motorola Solutions
Conference on Human Factors in Computing Systems - Proceedings | Year: 2011
Parenting a Very Low Birth Weight (VLBW) premature infant in the Neonatal Intensive Care Unit (NICU) and transitioning this infant home can be very stressful for parents. Few studies, however, examined the needs of parents of VLBW infants during the transition to home; moreover, even less is known about information and communication technology strategies to support parents during the transition period. To address this knowledge gap, we are conducting a study that aims to develop a mobile application/service to support the parents of VLBW infants by enhancing communication with the NICU staff and access to information resources. We report findings from our preliminary study using contextual inquiry and phone interviews and discuss implications for system development.
Duszak Jr. R.,University of Tennessee Health Science Center |
Berlin L.,NorthShore University
American Journal of Roentgenology | Year: 2010
Plaintiff's Attorney (Pl Att): Doctor, the record shows that the patient was referred to the hospital's radiology department by her gynecologist for a screening mammogram. The record also shows that when completing the mammography information form, the patient wrote that she had a lump in her left breast, correct? Defendant Radiologist (Df Rad): Yes. Pl Att: But your technologist performed, and you interpreted, a screening mammogram. Doesn't the radiology standard of care require you to do a diagnostic mammogram when the patient has a breast lump? Df Rad: Well, normally yes, but if it's going to be a diagnostic mammogram, then the referring physician has to order it. In this case our tech called the gynecologist and asked him whether he wanted to order a diagnostic study, and he said no, he didn't feel the lump, and that we should only do a plain screening mammogram. Pl Atty: Please explain something. You're agreeing that a woman with a breast lump should have a diagnostic mammogram, but you are saying that you didn't do one because the patient's physician wouldn't order it? Don't you have a duty to do the diagnostic mammogram in a case like this on your own, without having to ask permission from the patient's gynecologist? Df Rad: Only the treating physician can change a screening mammogram into a diagnostic mammogram, and I am not the treating physician. If I went ahead and did a diagnostic mammography examination on my own, it would be Medicare fraud, and our hospital's compliance officer says it could result in our hospital being fined and thrown out of the Medicare program. Pl Atty: What prevents you then from recommending - not ordering, but just recommending - a diagnostic mammogram in your report, because the patient says she's got a lump? Df Rad: Well, according to our hospital's compliance officer, that would also be fraud. © American Roentgen Ray Society.
Gupta S.,University of Pittsburgh |
Wang Y.,University of Pittsburgh |
Ramos-Garcia R.,University of Pittsburgh |
Shevrin D.,NorthShore University |
And 2 more authors.
Prostate | Year: 2010
BACKGROUND Intermittent androgen deprivation therapy (IADT) was developed to improve the quality of life and retard prostate cancer progression to castration resistance. IADT involves regrowth of the tumor during the off cycle upon testosterone recovery. Our previous studies showed that testosterone is more potent than dihydrotestosterone (DHT) in the induction of a subset of androgen-responsive genes during rat prostate regrowth. However, it is not clear if the same phenomenon would occur during androgen-induced regrowth of prostate tumors. Understanding the differences between testosterone and DHT in inducing androgen-responsive genes during prostate tumor regrowth may provide new insight for improving IADT. METHODS Nude mice bearing androgen-sensitive LNCaP xenograft were castrated and followed up for 7-10 days before being randomized into various androgen manipulations, consisting of continuous castration (C) or testosterone replacement (T) in the absence or presence of dutasteride (D), a 5α-reductase inhibitor that blocks the conversion of testosterone to DHT. Testes-intact animals in the absence or presence of D were used as controls. The expression of five androgen-responsive genes, including the tumor suppressor U19/Eaf2, was determined using real-time RT-PCR, 3 days after randomization. RESULTS In LNCaP tumors, the expression of U19/Eaf2 was higher in the T+D group as compared with T alone (2.87-fold, P < 0.05). In contrast, dutasteride treatment in testes-intact animals inhibited the expression of U19/Eaf2. CONCLUSIONS Inhibition of 5α-reductase during LNCaP tumor regrowth enhanced the expression of U19/Eaf2, an androgen-regulated tumor suppressor. This finding suggests that off cycle 5α-reductase inhibition may enhance the efficacy of IADT. © 2010 Wiley-Liss, Inc.
Homan E.P.,Baylor College of Medicine |
Rauch F.,McGill University |
Grafe I.,Baylor College of Medicine |
Lietman C.,Baylor College of Medicine |
And 16 more authors.
Journal of Bone and Mineral Research | Year: 2011
Osteogenesis imperfecta (OI) is a spectrum of genetic disorders characterized by bone fragility. It is caused by dominant mutations affecting the synthesis and/or structure of type I procollagen or by recessively inherited mutations in genes responsible for the posttranslational processing/trafficking of type I procollagen. Recessive OI type VI is unique among OI types in that it is characterized by an increased amount of unmineralized osteoid, thereby suggesting a distinct disease mechanism. In a large consanguineous family with OI type VI, we performed homozygosity mapping and next-generation sequencing of the candidate gene region to isolate and identify the causative gene. We describe loss of function mutations in serpin peptidase inhibitor, clade F, member 1 (SERPINF1) in two affected members of this family and in an additional unrelated patient with OI type VI. SERPINF1 encodes pigment epithelium-derived factor. Hence, loss of pigment epithelium-derived factor function constitutes a novel mechanism for OI and shows its involvement in bone mineralization. © 2011 American Society for Bone and Mineral Research Copyright © 2011 American Society for Bone and Mineral Research.
Schroeder G.D.,Northwestern University |
Lynch T.S.,Cleveland Clinic |
Gibbs D.B.,Northwestern University |
Chow I.,Northwestern University |
And 5 more authors.
Spine | Year: 2014
STUDY DESIGN.: Cohort study. OBJECTIVE.: To determine the effect of cervical spine pathology on athletes entering the National Football League. SUMMARY OF BACKGROUND DATA.: The association of symptomatic cervical spine pathology with American football athletes has been described; however, it is unknown how preexisting cervical spine pathology affects career performance of a National Football League player. METHODS.: The medical evaluations and imaging reports of American football athletes from 2003 to 2011 during the combine were evaluated. Athletes with a cervical spine diagnosis were matched to controls and career statistics were compiled. RESULTS.: Of a total of 2965 evaluated athletes, 143 players met the inclusion criteria. Athletes who attended the National Football League combine without a cervical spine diagnosis were more likely to be drafted than those with a diagnosis (P = 0.001). Players with a cervical spine diagnosis had a decreased total games played (P = 0.01). There was no difference in the number of games started (P = 0.08) or performance score (P = 0.38). In 10 athletes with a sagittal canal diameter of less than 10 mm, there was no difference in years, games played, games started, or performance score (P > 0.24). No neurological injury occurred during their careers. In 7 players who were drafted with a history of cervical spine surgery (4 anterior cervical discectomy and fusion, 2 foraminotomy, and 1 suboccipital craniectomy with a C1 laminectomy), there was no difference in career longevity or performance when compared with matched controls. CONCLUSION.: This study suggests that athletes with preexisting cervical spine pathology were less likely to be drafted than controls. Players with preexisting cervical spine pathology demonstrated a shorter career than those without; however, statistically based performance and numbers of games started were not different. Players with cervical spinal stenosis and those with a history of previous surgery demonstrated no difference in performance-based outcomes and no reports of neurological injury during their careers. Copyright © 2014 Lippincott Williams &Wilkins.
PubMed | Northwestern University and NorthShore University
Type: Comparative Study | Journal: Cancer | Year: 2016
Patients who receive adjuvant chemotherapy have reported cognitive impairments that may last for years after the completion of treatment. Working memory-related and long-term memory-related changes in this population are not well understood. The objective of this study was to demonstrate that cancer-related cognitive impairments are associated with the under recruitment of brain regions involved in working and recognition memory compared with controls.Oncology patients (n=15) who were receiving adjuvant chemotherapy and had evidence of cognitive impairment according to neuropsychological testing and self-report and a group of age-matched, education group-matched, cognitively normal control participants (n=14) underwent functional magnetic resonance imaging. During functional magnetic resonance imaging, participants performed a nonverbal n-back working memory task and a visual recognition task.On the working memory task, when 1-back and 2-back data were averaged and contrasted with 0-back data, significantly reduced activation was observed in the right dorsolateral prefrontal cortex for oncology patients versus controls. On the recognition task, oncology patients displayed decreased activity of the left-middle hippocampus compared with controls. Neuroimaging results were not associated with patient-reported cognition.Decreased recruitment of brain regions associated with the encoding of working memory and recognition memory was observed in the oncology patients compared with the control group. These results suggest that there is a reduction in neural functioning postchemotherapy and corroborate patient-reported cognitive difficulties after cancer treatment, although a direct association was not observed. Cancer 2016;122:258-268. 2015 American Cancer Society.