Surgery Commons^™

Autologous Peripheral Nerve Grafts To The Brain For The Treatment Of Parkinson's Disease, Andrew Welleford

Theses and Dissertations--Neuroscience

Parkinson’s disease (PD) is a disorder of the nervous system that causes problems with movement (motor symptoms) as well as other problems such as mood disorders, cognitive changes, sleep disorders, constipation, pain, and other non-motor symptoms. The severity of PD symptoms worsens over time as the disease progresses, and while there are treatments for the motor and some non-motor symptoms there is no known cure for PD. Thus there is a high demand for therapies to slow the progressive neurodegeneration observed in PD. Two clinical trials at the University of Kentucky College of Medicine (NCT02369003, NCT01833364) are currently underway that …

Effect Of Neoadjuvant Chemoradiation On Preoperative Pulmonary Physiology, Postoperative Respiratory Complications And Quality Of Life In Patients With Oesophageal Cancer, J. A. Elliott, L. O'Byrne, G. Foley, C. F. Murphy, Suzanne Doyle, S. King, E. M. Guinan, N. Ravi, V. Reynolds

Articles

Background: It remains controversial whether neoadjuvant chemoradiation (nCRT) for oesophageal cancer influences operative morbidity, in particular pulmonary, and quality of life. This study combined clinical outcome data with systematic evaluation of pulmonary physiology to determine the impact of nCRT on pulmonary physiology and clinical outcomes in locally advanced oesophageal cancer.

Methods: Consecutive patients treated between 2010 and 2016 were included. Three-dimensional conformal radiation was standard, with a lung dose–volume histogram of V20 less than 25 per cent, and total radiation between 40 and 41⋅4Gy. Forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and diffusion capacity …

Depression Screening For Bariatric Surgical Patients, Cova Teresa Stidham

Walden Dissertations and Doctoral Studies

Obesity in the United States has increased to epidemic numbers over the last decade. Practitioners need to reverse the trend. To address the problem of depression in obesity, a practice guideline from a bariatric clinic for under-served populations was proposed to an expert panel. The Spell Out on First Use (PHQ-9) screening is a valid and reliable self-screening tool to assist the practitioner in determining the level of depression if any. The PHQ-9 has nine questions. No formal screening existed at the bariatric clinic, and the practice guideline (with algorithm and revised workflow) was proposed for use at the clinic. …

Who Is Pirating Medical Literature? A Bibliometric Review Of 28 Million Sci-Hub Downloads., Brian M. Till, Niclas Rudolfson, Saurabh Saluja, Jesudian Gnanaraj, Lubna Samad, David Ljungman, Mark Shrime

Department of Surgery Faculty Papers

We aimed to define the proportion of downloads on Sci-Hub that are medical in nature and to consider these data at the national level, evaluating the relation between density of medical literature downloads and scientific output, national income classifications, and indicators of internet penetrance.

Prior History Of Anterior Cruciate Ligament (Acl) Reconstruction Is Associated With A Greater Risk Of Subsequent Acl Injury In Female Collegiate Athletes, Jason Brumitt, Alma Mattocks, Amy Engilis, Dale Isaak, Jeremy Loew

Faculty Publications - College of Physical Therapy

Objectives: The risk of a subsequent anterior cruciate ligament (ACL) sprain is greater in high school aged female athletes with prior history of ACL reconstruction (ACLR) than in age-matched controls. The risk of a subsequent ACL injury in female collegiate athletes with prior ACLR is unknown. The primary purpose of this study was to determine the relative risk of a subsequent ACL injury in female collegiate athletes with prior ACLR when compared to age-matched controls. The secondary purpose of this study was to evaluate the ability of jump and hop tests to discriminate ACL injury risk.

Design: Prospective cohort.

Methods: …

Human Papillomavirus And Human Cytomegalovirus Infection And Association With Prognosis In Patients With Primary Glioblastoma In Pakistan, Syed Adnan Ali, Yumna Mirza, Zubair Ahmad, Nida Zahid, Ather Enam

Department of Surgery Docs

Objective: Glioblastoma multiforme (GBM) is the most common adult primary brain tumor. Human cytomegalovirus (HCMV) has been studied for the past decade, and conflicting results have been reported with no conclusive role established yet. Human papillomavirus (HPV) is involved in the pathogenesis of many cancers and has a high prevalence in patients with cervical and oral cancer in Pakistan. The objective of our study was to identify the prevalence of HCMV and HPV in Pakistani patients with primary GBM.
Methods: In total, 112 primary GBM biopsies were analyzed. HCMV and HPV infection was investigated using nested and conventional polymerase chain …

Is The Use Of A Fresh-Frozen Allograft More Effective Than A Hamstring Autograft In Preserving Functional Knee Ability Post-Surgery In Acl Reconstruction?, Carly E. Black

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of the selective EBM review is to determine whether or not, “Is the use of fresh-frozen allograft more effective than a hamstring autograft in preserving functional knee ability post-surgery in ACL reconstruction?”

STUDY DESIGN: Review of two randomized control trials (RCTs) and one prospective randomized study published between 2011 and 2016, all in English language. The articles compared allograft tendon versus autograft tendon when undergoing ACL reconstructive surgery.

DATA SOURCES: Two randomized control trials (RCTs) and one prospective randomized study were found using PubMed, NCBI, and Cochrane databases. All articles were published in reviewed journals and selected …

Is Aromatherapy Effective In Treating Emotional Instability In Women Undergoing Surgical Breast Procedures?, Stephanie Deem

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “Is aromatherapy effective in treating emotional instability in women undergoing surgical breast procedures?”

Study Design: Systematic review of one single-site, randomized study, one randomized control trial, and one randomized, placebo-controlled study, all English language, one published in 2016 and two published in 2017.

Data Sources: Studies were published in peer-reviewed journals and researched via the PubMed Database.

Outcomes Measured: All of the articles analyzed the effectiveness of aromatherapy in treating emotional instability in women undergoing surgical breast procedures. Improved emotional instability was …

Is Intranasal Ketorolac Both Safe And Effective In Reducing Acute Postoperative Pain For Patients Over 18 Years Of Age That Require Inpatient Hospitalization?, Courtney Koukal

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not intranasal ketorolac is both safe and effective in reducing acute postoperative pain for patients over 18 years of age that require inpatient hospitalization.

STUDY DESIGN: Review of three double-blind randomized controlled trials (RCTs) were used, all are from 2008 to present and all are in the English language.

DATA SOURCES: Data sources include articles that were published on both PubMed and Cochrane databases and were selected based on their relevance to the research question as well as patient measured outcomes.

OUTCOMES MEASURED: Outcomes measured include efficacy …

Is Postoperative Consumption Of Coffee Effective In Reducing Postoperative Ileus?, Samantha L. Moran

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is postoperative consumption of coffee effective in reducing postoperative ileus?”

STUDY DESIGN: Review of three randomized controlled trials written in the English language and were published in 2017, 2015, and 2012.

DATA SOURCES: Three randomized control trials were found via PubMed.

OUTCOMES MEASURED: Time in days from the end of surgery until the first passage of stool recorded by patient, or time measured in hours reported by nursing staff.

RESULTS: Dulkskas, et al. (2015) found that the time until the first bowel movement (measured in days) …

Does The Ligasure Vessel Sealing System Provide Benefit In Mortality In Regards To Hepatic Resections?, Samantha M. Kleiber

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not using the LigaSure device provides any benefit in morality in patients undergoing hepatic resection surgery.

STUDY DESIGN: Review of three English language randomized control trials published in 2007, 2009 and 2012.

DATA SOURCES: Data sources obtained for this review primary studies published in peerreviewed journals, found using PubMed.

OUTCOMES MEASURED: Patient mortality, defined as death within 30 days of the surgical procedure.

RESULTS: The study done by Doklestic and et al had 3 patient mortalities occur. The deaths occurred on post op days three, four and …

Successful Brace Treatment Of Pectus Carinatum In Osteogenesis Imperfecta Using The Dynamic Compression System., Beth A. Orrick, Amy L. Pierce, Charles L. Snyder, Uri S. Alon

Manuscripts, Articles, Book Chapters and Other Papers

Osteogenesis imperfecta (OI) is a genetic disorder of collagen resulting in a "fragile" skeleton with increased fracture risk and other complications, dependent on the specific variant. Pectus deformities of the chest wall, while not common, can be associated with OI. The use of a pectus carinatum brace in a patient with OI poses unknown risks for fractures and adverse treatment outcomes. We successfully applied external compression bracing using the dynamic compression system to one such patient. This case illustrates the ability to treat an OI patient with pectus carinatum using a nonsurgical brace, without complications, resulting in an excellent cosmetic …

A Systematic Review Of Observational Studies, Demonstrating Smoking Among School Going Adolescents, Shafquat Rozi, Gillian Lancaster, Sadia Mahmud, Zahid Ahmad Butt, Talat Roome, Nida Zahid

Community Health Sciences

Objective: To characterize the methods of design and analysis currently adopted in survey research of school-based observational studies for smoking, and to identify the common pitfalls made by researchers.
Methods: The systematic review was conducted in 2009 and consisted of observational studies in school settings published between January 2005 and January 2009. Smoking status was the main outcome of interest. Following Cochrane style, five steps were followed: setting selection criteria for studies and conducting a literature search; review of abstracts; review of complete articles; data extraction and quality assessment of included studies; and, finally, synthesis of studies.
Results: Of the …

Implantable Biomaterials To Provide Local Immunotherapy Following Surgical Resection., Michael J Gough, Jason R Baird, R Bryan Bell

Articles, Abstracts, and Reports

No abstract provided.

The Addition Of Simvastatin Administration To Cold Storage Solution Of Explanted Whole Liver Grafts For Facing Ischemia/Reperfusion Injury In An Area With A Low Rate Of Deceased Donation: A Monocentric Randomized Controlled Double-Blinded Phase 2 Study., Duilio Pagano, Elisabetta Oliva, Simone Khouzam, Fabio Tuzzolino, Davide Cintorino, Sergio Li Petri, Fabrizio Di Francesco, Calogero Ricotta, Pasquale Bonsignore, Alessandro Tropea, Sergio Calamia, Federico Costanzo, Angelo Luca, Salvatore Gruttadauria

Student Papers, Posters & Projects

BACKGROUND: Liver transplantation is the best treatment for end-stage liver disease. The interruption of the blood supply to the donor liver during cold storage damages the liver, affecting how well the liver will function after transplant. The drug Simvastatin may help to protect donor livers against this damage and improve outcomes for transplant recipients. The aim of this study is to evaluate the benefits of treating the donor liver with Simvastatin compared with the standard transplant procedure.

PATIENT AND METHODS: We propose a prospective, double-blinded, randomized phase 2 study of 2 parallel groups of eligible adult patients. We will compare …

Interpersonal Violence In Peacetime Malawi., Rebecca G. Maine, Brittney Williams, Jennifer A. Kincaid, Gift Mulima, Carlos Varela, Jared R. Gallaher, Trista D. Reid, Anthony G. Charles

Department of Surgery Faculty Papers

Background: The contribution of interpersonal violence (IPV) to trauma burden varies greatly by region. The high rates of IPV in sub-Saharan Africa are thought to relate in part to the high rates of collective violence. Malawi, a country with no history of internal collective violence, provides an excellent setting to evaluate whether collective violence drives the high rates of IPV in this region.

Methods: This is a retrospective review of a prospective trauma registry from 2009 through 2016 at Kamuzu Central Hospital in Lilongwe, Malawi. Adult (>16 years) victims of IPV were compared with non-intentional trauma victims. Log binomial …

The Current Understanding Of Microrna's Therapeutic, Diagnostic, And Prognostic Role In Chordomas: A Review Of The Literature., Paul J Choi, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

Chordomas are primary low-grade bone tumors derived from the embryonic notochord that make up less than 5% of all osseous malignancies and commonly affect the spine at its vertebral body and at its two ends i.e., skull base and the sacrum. Although histologically defined to be low-grade, chordoma is locally destructive, metastatic, and has a serious recurrence rate, which all contribute to the dismal median survival rate of six years. Its locally destructive nature places the adjacent vital neurovascular structures at risk, making an en-bloc resection a challenge. This tumor is also known to show high resistance to currently available …

Transgenic Mice Overexpressing Human Tnf-Α Experience Early Onset Spontaneous Intervertebral Disc Herniation In The Absence Of Overt Degeneration., Deborah J. Gorth, Irving M. Shapiro, Makarand V. Risbud

Department of Orthopaedic Surgery Faculty Papers

There is a well-established link between cytokine expression and the progression of intervertebral disc degeneration. Among these cytokines, interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) are the most commonly studied. To investigate whether systemic hTNF-α overexpression affects intervertebral disc health, we studied the spine phenotype of Tg197 mice, a widely used hTNF-α transgenic line. These mice were studied at 12-16 weeks of age using comprehensive histochemical and immunohistological analysis of the spinal motion segment. Micro-CT analysis was performed to quantify vertebral trabecular bone architecture. The Tg197 mice evidenced spontaneous annular tears and herniation with increased vascularity in subchondral bone and …

Isolated Gonococcal Extensor Tenosynovitis, Cory Lebowitz, Jonas Matzon

Department of Orthopaedic Surgery Faculty Papers

Neisseria gonorrhoeae is a mucosal infection that has the propensity to disseminate, causing symptoms that commonly include arthralgias, skin lesions, fevers, chills, dysuria, genital discharge, septic arthritis, and/or tenosynovitis. Typically, gonococcal tenosynovitis affects the flexor sheath and is associated with arthralgias, skin lesions, or both. To the best of our knowledge, there has not been a documented case of isolated gonococcal extensor tenosynovitis. We report the case of a 16-year-old boy with isolated left upper-extremity gonococcal extensor tenosynovitis who was successfully treated with surgical debridement and antibiotic therapy.

Metabolic Dependencies In Pancreatic Cancer., Ali Vaziri-Gohar, Mahsa Zarei, Jonathan R. Brody, Jordan M. Winter

Department of Surgery Faculty Papers

Pancreatic ductal adenocarcinoma (PDA) is a highly lethal cancer with a long-term survival rate under 10%. Available cytotoxic chemotherapies have significant side effects, and only marginal therapeutic efficacy. FDA approved drugs currently used against PDA target DNA metabolism and DNA integrity. However, alternative metabolic targets beyond DNA may prove to be much more effective. PDA cells are forced to live within a particularly severe microenvironment characterized by relative hypovascularity, hypoxia, and nutrient deprivation. Thus, PDA cells must possess biochemical flexibility in order to adapt to austere conditions. A better understanding of the metabolic dependencies required by PDA to survive and …