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News Article | March 17, 2017

Spinal deformity is caused due to unnatural curvature and it takes place mostly due to any defect, or damage caused to the spine. Patients who are suffering from spinal deformity are at greater risk of dislocation following a hip replacement surgery if a new study is to be believed. The study was conducted by orthopedic surgeons of the NYU Langone Medical Center. The research includes a detailed observation of the affects of spinal deformity on the pelvis. It states the risks which are involved in such cases, while surgeons try to attach the artificial hip during a replacement surgery. During a hip replacement surgery, the surgeon attaches an artificial joint which includes a socket and a ball to the natural sockets located in the pelvis of the patient. Surgeons have tried to attach the socket or the acetabular cup adjoining the pelvic bone, which according to them is a safe zone or is a place where there are less chances of dislocation. This process has been used by surgeons for years. However, a new study suggests that attaching the artificial cup at the safe area is not sufficient to avoid dislocations in patients suffering from deformity. During the research, the investigators studied 107 patients who had been affected with sagittal spinal deformity. They also reviewed 139 patients who had undergone a hip replacement surgery. The detailed report of the measurements of the patients taken before and after the surgery were analyzed. The researchers studied the dynamic changes which took place in the acetabular cup position, and also inquired the instability rate in the patients who underwent hip replacement surgery. The investigators found that the dislocation rate is 8 percent for patients who are suffering from some kind of spinal stenosis. About 5.8 percent patients required another operation because of the reoccurrence of the dislocation. "The fact that high rates of dislocation occurred in patients with 'safe zone' placement of their artificial hips implies that our understanding of what defines acceptable acetabular positioning for these patients remains questionable," said Jonathan Vigdorchik, Assistant Professor of Orthopedic Surgery in NYU Langone. These findings have led orthopedic surgeons at NYU Langone to work together with other spine surgeons. They intend to work on planning preoperative measures, which should be taken to achieve the best possible results for hip replacement surgeries. The researchers are also planning to examine ways through which further dislocation risks, that are involved in hip replacement surgeries, can be reduced. This research was presented at the at the American Academy of Orthopedic Surgeons (AAOS) 2017 Annual Meeting in San Diego, California on March 17. The study is available online in the Journal of Arthroplasty. © 2017 Tech Times, All rights reserved. Do not reproduce without permission.

News Article | May 3, 2017

Long thought to simply pass on information received from the senses, the thalamus may also quickly assemble the circuits that enable successful decisions. This newfound function for this small, center-brain region is the main finding of a study led by researchers from NYU Langone Medical Center and published May 3 in the journal Nature. The study focuses on the part of the thalamus associated with the prefrontal cortex or PFC, the brain region traditionally linked to "executive functions" like working memory, the ability to focus attention, and decision-making. Using live mice and computer simulations of neural circuits, the study authors found that the "mediodorsal" thalamus strengthens connections within the PFC rather than strictly relay information to the cortex as previously thought. This strengthening informs decisions by enabling PFC circuits to "hold in mind" experience-based rules on what to pay attention to, say the authors. "Our study provides the clearest demonstration to date that the mediodorsal thalamus or MD may be the conductor of connectivity between circuits as the brain attends to previously learned rules and makes decisions in real time," says study senior investigator Michael Halassa, MD, PhD, an assistant professor at NYU Langone's Neuroscience Institute. "This new understanding also implicates the thalamus in cognitive deficits that come with diseases known to proceed from connection problems in the cortex, from attention deficits to the psychosis seen in schizophrenia to sleep problems," says Halassa. "Our results support the theory that cognition in general could be improved by adjusting thalamic function." In the current study, researchers examined how the MD and PFC interact as mice used experience-based rules to determine which sensory stimuli to pay attention to (flash of light versus sound) to gain access to a food reward. The researchers found that enhancing MD activity magnified the ability of mice to "think," driving down by more than 25 percent their error rate in deciding which conflicting sensory stimuli to follow to find the reward. To the contrary, increasing the activity of prefrontal cortex directly destroyed the ability of the mice to make the right decision based on previous training (drove success down to a 50/50 chance in some cases). The interpretation is that this caused interconnected cortical circuits encoding conflicting rules to fire at the same time. The experiments suggest a new theory for how the mammalian brain operates, says Halassa. It may have developed the flexibility to make complex decisions by wiring the many associations on which decisions depend into weakly connected cortical circuits. This strategy would only work though if the thalamus was there to amplify the connectivity (signaling strength) of just the circuits in the cortex appropriate for the current context. In terms of methods, Halassa and colleagues stitched into a certain spot in the DNA of nerve cells in these mice the code for a light-sensitive protein. With that in place, the team was able to turn on nerve cell signaling in the MD and PFC by shining light. At the same time, the team had implanted electrodes that measure patterns of nerve cell activity. The team then designed a test with steps that required mice to consider and combine sensory clues over time to find food as the team recorded brain circuit activity. Halassa says that these precise regimens have enabled his team to perform sophisticated behavioral tests in mice that were once done in non-human primates. Along with Halassa, the study was conducted by first author L. Ian Schmitt, Ralf Wimmer, Miho Nakajima, Sima Mofakham, and Michael Happ in the NYU Langone Neuroscience Institute. The study was funded supported by grants from the National Institute of Mental Health, the National Institute of Neurological Disorders and Stroke, the Brain and Behavior Research Foundation, the Sloan and Klingenstein foundations, and the Human Frontiers Science Program.

Rosenkrantz A.B.,NYU Langone Medical Center
American Journal of Roentgenology | Year: 2016

OBJECTIVE. The purpose of this study was to characterize trends related to retracted publications within radiology journals. MATERIALS AND METHODS. PubMed was queried to identify all articles with the publication type "retracted publication" or "notification of retraction." Articles published within radiology journals were identified using Journal Citation Reports' journal categories. Available versions of original articles and publication notices were accessed from journal websites. Citations to retracted publications were identified using Web of Science. Overall trends were assessed. RESULTS. Forty-eight retracted original research articles were identified within radiology journals since 1983, which included 1.1% of all PubMed "retracted publication" entries. Distinct PubMed entries were available for the retracted publication and retraction notification in 39 of 48 articles. The original PDF was available for 37 articles, although the articles were not watermarked as retracted in 23 cases. In six cases with a watermarked PDF, further searches identified nonwatermarked versions. Original HTML versions were available for 13 articles but 11 were not watermarked. The mean (± SD) delay between publication and retraction was 2.7 ± 2.8 years (range, 0-16 years). The mean number of citations to retracted articles was 10.9 ± 17.1 (range, 0-94 citations). Reasons for retraction included problematic or incorrect methods or results (although it typically was unclear whether these represented honest errors or misconduct) in 33.3% of cases, complete or partial duplicate publication in 33.3% of cases, plagiarism in 14.6% of cases, a permission issue in 8.3% of cases, the publisher's error in 6.3% of cases, and no identified reason in 6.3% of cases. One or no retractions occurred annually from 1986 to 2001, although two or more retractions occurred annually in nine of the 12 years from 2002 through 2013. CONCLUSION. Retraction represents an uncommon, yet potentially increasing, issue within radiology journals that publishers have inconsistently and insufficiently addressed. Greater awareness and training in proper biomedical research conduct, as well as establishment and enforcement of standardized publishers' policies, are warranted. © American Roentgen Ray Society.

Axsom K.,NYU Langone Medical Center
Current atherosclerosis reports | Year: 2013

The ability for statins to reduce major cardiovascular events and mortality has lead to this drug class being the most commonly prescribed in the world. In particular, the benefit of these drugs in type 2 diabetes (T2D) is well established. In February 2012, the Food and Drug Administration released changes to statin safety label to include that statins have been associated with increases in hemoglobin A1C and fasting serum glucose levels. This has stirred much debate in the medical community. Estimate for new onset diabetes from statin treatment is approximately one in 255 patients over four years. The number needed to treat for statin benefit is estimated at one in 40 depending on the population. The mechanism of this link remains unknown. Statins may accelerate progression to diabetes via molecular mechanisms that impact insulin resistance and cellular metabolism of carbohydrates. It remains clear that the benefit of statin therapy outweighs the risk of developing diabetes.

As health care reform continues to evolve, there will need to be an emphasis on generating value, quality improvement, and cost control. In 2011, the Centers for Medicare and Medicaid Services (CMS) initiated a new Bundled Payment for Care Improvement initiative. Early results from this CMS bundled payment initiative at an urban, tertiary, academic medical center demonstrate decreased length of stay and increased discharge to home, with decreasing readmission rates, which can result in cost-savings without compromise of the quality of care. Changes in care coordination, clinical care pathways, and evidence-based protocols are the key to improving the quality metrics and cost effectiveness within the implementation of the bundled payment for care initiative, thus bringing increased value to our total joint arthroplasty patients. © 2015 Elsevier Inc.

Both oxytocin and oxytocin receptors are implicated in neuropsychiatric disorders, particularly autism which involves a severe deficit in social cognition. Consistently, oxytocin enhances social cognition in humans and animals. The infralimbic medial prefrontal cortex (IL-mPFC) is believed to play an important role in the regulation of social cognition which might involve top-down control of subcortical structures including the amygdala. However, little is known about whether and how oxytocin modulates synaptic function in the IL-mPFC. The effect of oxytocin on excitatory neurotransmission in the IL-mPFC was studied by examining both the evoked and spontaneous excitatory neurotransmission in the IL-mPFC layer V pyramidal neurons before and after perfusion with oxytocin. To investigate the effect of oxytocin on synaptic plasticity, low-frequency stimulation-induced long-lasting depression was studied in oxytocin-treated brain slices. Oxytocin produced a significant suppression of glutamatergic neurotransmission in the IL-mPFC layer V pyramidal neurons which was mediated by a reduction in glutamate release. Activation of the cannabinoid CB1 receptors was involved in this pre-synaptic effect. Treatment of brain slices with oxytocin for 1 h converted long-lasting depression into long-lasting potentiation of glutamatergic neurotransmission. This oxytocin-mediated plasticity was NMDA receptor-dependent and was mediated by the synaptic insertion of calcium-permeable α-amino-3-hydroxy-5-methyl- 4-isoxazole propionic acid receptors. The aforementioned suppression of basal glutamatergic neurotransmission and facilitation of activity-dependent synaptic plasticity in the IL-mPFC might be critical for the effect of oxytocin on social cognition. © 2011 International Society for Neurochemistry.

Bosniak M.A.,NYU Langone Medical Center
Radiology | Year: 2012

In the past 25 years, there have been continuous advances in the diagnosis of disease throughout the body owing to the introduction of new technology and the experience gained with its use. However, the imaging and evaluation of complicated cystic lesions of the kidneys frequently remains a difficult problem. The classification of renal cystic lesions suggested 25 years ago, now referred to as the Bosniak renal cyst classification, remains pertinent to the diagnosis and management of these difficult-to-diagnose complicated cystic masses. © RSNA, 2011.

Gourevitch M.N.,NYU Langone Medical Center
Academic Medicine | Year: 2014

Optimizing the health of populations, whether defined as persons receiving care from a health care delivery system or more broadly as persons in a region, is emerging as a core focus in the era of health care reform. To achieve this goal requires an approach in which preventive care is valued and "nonmedical" determinants of patients' health are engaged. For large, multimission systems such as academic medical centers, navigating the evolution to a population-oriented paradigm across the domains of patient care, education, and research poses real challenges but also offers tremendous opportunities, as important objectives across each mission begin to align with external trends and incentives. In clinical care, opportunities exist to improve capacity for assuming risk, optimize community benefit, and make innovative use of advances in health information technology. Education must equip the next generation of leaders to understand and address population-level goals in addition to patient-level needs. And the prospects for research to define strategies for measuring and optimizing the health of populations have never been stronger. A remarkable convergence of trends has created compelling opportunities for academic medical centers to advance their core goals by endorsing and committing to advancing the health of populations.

Erlebacher A.,NYU Langone Medical Center
Annual Review of Immunology | Year: 2013

The immune cells that reside at the interface between the placenta and uterus are thought to play many important roles in pregnancy. Recent work has revealed that the composition and function of these cells are locally controlled by the specialized uterine stroma (the decidua) that surrounds the implanted conceptus. Here, I discuss how key immune cell types (natural killer cells, macrophages, dendritic cells, and T cells) are either enriched or excluded from the decidua, how their function is regulated within the decidua, and how they variously contribute to pregnancy success or failure. The discussion emphasizes the relationship between human and mouse studies. Deeper understanding of the immunology of the maternal-fetal interface promises to yield significant insight into the pathogenesis of many human pregnancy complications, including preeclampsia, intrauterine growth restriction, spontaneous abortion, preterm birth, and congenital infection. © Copyright 2013 by Annual Reviews. All rights reserved.

Megibow A.J.,NYU Langone Medical Center
AJR. American journal of roentgenology | Year: 2012

OBJECTIVE: The purpose of this perspective is to document an experience with the adoption of dual-energy CT (DECT) for routine clinical imaging. CONCLUSION: Successful implementation of DECT requires that technologists understand standards of image quality, be empowered to select appropriate patients, and understand networks for image routing. Radiologists need minimal facility with workstations to access the information embedded in DECT. DECT can be performed at a reduced effective radiation dose compared with single-energy CT and with lower doses of IV contrast material.

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