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Evanston, IL, United States

Dunlap B.J.,Northshore University Health Systems | Ferkel R.D.,Southern California Orthopedic Institute
Arthroscopy - Journal of Arthroscopic and Related Surgery | Year: 2013

Purpose The purpose of this study was to assess a series of lateral inverted osteochondral fractures of the talus. Methods Over a 17-year period, 10 patients with an acute lateral inverted osteochondral fracture of the talus after an inversion injury to the ankle were identified. Diagnosis was made by physical examination, radiographs, magnetic resonance imaging, and/or computed tomography scan. Arthroscopy was initially performed on all patients. All patients had an inverted osteochondral fragment. In 8 of 10 patients the fragment was reattached in an open manner in conjunction with lateral ligament reefing. The fragment was excised in 2 patients. The mean age of the patients was 17.2 years. They were evaluated with the Single Assessment Numeric Evaluation, American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale, modified Weber score, Berndt and Harty score, and Short Form 36 version 2 score. Physical and radiographic examination was also performed. The mean time to follow-up was 112.3 months (9.3 years). Results The mean American Orthopaedic Foot and Ankle Society score improved from 18.9 preoperatively to 86.9 postoperatively (P ≤.0001). The mean Single Assessment Numeric Evaluation and modified Weber scores were 81.6 and 81.5, respectively. On the Berndt and Harty scale, 6 patients had a good to excellent rating; 3, fair; and 1, poor. The mean Short Form 36 version 2 scores corresponded to national averages for healthy populations. Mean loss of motion for dorsiflexion and plantarflexion was 6.8 and 3.0, respectively, when compared with the contralateral side. All patients showed some osteophyte formation on follow-up radiographs. Conclusions An inverted osteochondral fracture of the lateral talus (lateral, inverted, fracture, talus [LIFT lesion]) can occur after a twisting injury to the ankle. Clinical suspicion should be high, especially in the younger athlete. This injury can be successfully managed with a combined arthroscopic and open approach. Level of Evidence Level IV, therapeutic case series. © 2013 The Arthroscopy Association of North America. Published by Elsevier Inc. All Rights Reserved.

Garfield C.F.,Northwestern University | Isacco A.,Chatham University | Bartlo W.D.,Northshore University Health Systems
International Journal of Men's Health | Year: 2010

A sample of U.S. urban fathers was studied using in-depth qualitative interviews to better understand how having children might influence the fathers' health and health behaviors. Over three-quarters of the men reported positive changes to their health behaviors since becoming fathers. The specific examples cited as positive changes by fathers included; positive changes in diet, increased frequency of exercise and physical activity, taking better care of themselves in general, decreased alcohol use, and less risk-taking behavior. A key shift is also identified in men's perspectives around the transition to fatherhood. Recommendations are provided to clinicians who seek to design interventions that reengage men in the health care system and caring for their health. © 2010 by the Men's Studies Press, LLC. All rights reserved.

Yin S.,Childrens Memorial Hospital | Wahl M.,University of Illinois at Chicago | Wahl M.,Northshore University Health Systems | Wahl M.,University of Chicago
American Journal of Drug and Alcohol Abuse | Year: 2011

Objectives: We sought to describe the demographics and trends of Coricidin product abuse in children in Illinois and to calculate an approximate total charge to the health-care system. Methods: In this retrospective database review, we identified 652 cases of intentional exposure to Coricidin products among children <18 years old in the Illinois Poison Center database from 2001 to 2006. Demographic, historical, clinical, and outcome data were recorded. Results: The mean (standard deviation) age was 15.7 (1.58) years. A significant increase in exposures occurred during the study period which showed a cyclic nature with peaks in the fall months. Of the patients with disposition data available, 28.6% were admitted to a critical care unit, 15.2% to a noncritical care hospital unit, 6.3% were admitted for inpatient psychiatric care, and 46.4% were evaluated in the emergency department and discharged home. Moderate or major outcomes were reported in 42.7% of cases in which data were available. No deaths were reported. The total approximate hospital charge was $2,119,881.90 or $353,313.65/year. Conclusions: Intentional abuse of Coricidin products reported to the poison center occurred primarily among adolescents and was often associated with significant short-term clinical effects and a clear financial burden to the health-care system. Scientific Significance: This investigation demonstrates that Coricidin product abuse continues to be a problem particularly among adolescents. Parents and clinicians need to continue to be aware of these substances as drugs of abuse and curbing sales to adolescents should be considered. © 2011 Informa Healthcare USA, Inc.

Dubord P.J.,University of British Columbia | MacSai M.S.,University of Chicago | MacSai M.S.,Northshore University Health Systems | Mannis M.J.,University of California at Davis | And 4 more authors.
Cornea | Year: 2013

PURPOSE: Evidence of the transmission of disease via donor ocular tissue has been demonstrated for adenocarcincoma, rabies, hepatitis B virus, cytomegalovirus, herpes simplex virus, Creutzfeldt-Jakob disease, and a variety of bacterial and fungal infections. METHODS: Although there is no evidence to date of disease transmission for HIV infection, syphilis, hepatitis C, hepatitis A, tuberculosis, HTLV-1 and -2 infection, active leprosy, active typhoid, smallpox, and active malaria, these entities remain contraindications for transplantation for all eye banks nationally and internationally. The potential sources of contamination include infected donors, during the process of removing tissue from cadaveric donors, the processing environment, and contaminated supplies and reagents used during processing. The transmissions of Herpes simplex virus and HSV via corneal graft have been shown to be responsible for primary graft failure. HSV-1 may also be an important cause of PFG. RESULTS: The long latency period of some diseases, the emergence of new infectious disease, and the reemergence of others emphasize the need for long-term record maintenance and effective tracing capabilities. CONCLUSIONS: The standardization of definitions for adverse events and reactions will be necessary to support the prevention and transmission of disease. International classification of a unique identification system for donors will be increasingly important for vigilance and traceability in cross-national exportation of human cells, tissues, and cellular- and tissue-based products. Opportunities for continuous improvement exist as does the need for constant vigilance and surveillance. Copyright © 2013 by Lippincott Williams & Wilkins.

Abbott D.E.,Northwestern University | Margaryan N.V.,Childrens Memorial Research Center | Jeruss J.S.,Northwestern University | Khan S.,Northwestern University | And 6 more authors.
Cancer Biology and Therapy | Year: 2010

Cathepsin D is a lysosomal hydrolase involved in intra- and extracellular proteolysis. This enzyme is aberrantly produced and processed in malignancy, and most notably is over-secreted into the tumor cell microenvironment. This hypersecretion may lead to excessive degradation of the extracellular matrix, and contribute to tumor progression and metastases. These phenomena have been established in vitro, and there is evidence that Cathepsin d is similarly dysregulated in human breast cancer patients. Because breast cancer lacks an effective screening or surveillance biomarker, here we address the hypothesis that serum Cathepsin d activity may be useful to assess the presence or progression of breast cancer in females. While representative histologic sections from various disease-specific cohorts confirm previous findings that increased Cathepsin d production and secretion correlate with tumor progression, we report no difference in serum Cathepsin d activity between patients who are disease free, patients with pre-invasive or limited invasive disease, and patients with metastatic disease. Furthermore, in patients with known metastatic disease, there were no clinical variables associated with significantly different serum Cathepsin D activity. However, the immunohistochemical localization of Cathepsin d expression in histopathologic sections from breast cancer patients correlates with disease progression. Based on the serum results, and in contradistinction to Cathepsin D localization in breast cancer tissues, our findings support using Cathepsin d as a reliable histopathology biomarker for disease progression, but not for serum screening. © 2010 Landes Bioscience.

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