نتائج البحث - "Heffernan, Michael P"

1

دورية

Lowest instrumented vertebrae in early onset scoliosis: is there a role for a more selective approach?

المؤلفون: Heffernan, Michael J., Leonardi, Claudia, Andras, Lindsay M., Fontenot, Bailli, Drake, Luke, Pahys, Joshua M., Smith, John T., Sturm, Peter F., Thompson, George H., Glotzbecker, Michael P., Tetreault, Tyler A., Roye, Benjamin D., Li, Ying

المصدر: Spine Deformity; July 2024, Vol. 12 Issue: 4 p1145-1153, 9p

مستخلص: Purpose: This purpose of this study was to assess the impact of patient and implant characteristics on LIV selection in ambulatory children with EOS and to assess the relationship between the touched vertebrae (TV), the last substantially touched vertebrae (LSTV), the stable vertebrae (SV), the sagittal stable vertebrae (SSV), and the LIV. Methods: A multicenter pediatric spine database was queried for patients ages 2–10 years treated by growth friendly instrumentation with at least 2-year follow up. The relationship between the LIV and preoperative spinal height, curve magnitude, and implant type were assessed. The relationships between the TV, LSTV, SV, SSV, and the LIV were also evaluated. Results: Overall, 281 patients met inclusion criteria. The LIV was at L3 or below in most patients with a lumbar LIV: L1 (9.2%), L2 (20.2%), L3 (40.9%), L4 (29.5%). Smaller T1 − T12 length was associated with more caudal LIV selection (p= 0.001). Larger curve magnitudes were similarly associated with more caudal LIV selection (p= < 0.0001). Implant type was not associated with LIV selection (p= 0.32) including MCGR actuator length (p= 0.829). The LIV was caudal to the TV in 78% of patients with a TV at L2 or above compared to only 17% of patients with a TV at L3 or below (p< 0.0001). Conclusions: Most EOS patients have an LIV of L3 or below and display TV–LIV and LSTV–LIV incongruence. These findings suggest that at the end of treatment, EOS patients rarely have the potential for selective thoracic fusion. Further work is necessary to assess the potential for a more selective approach to LIV selection in EOS. Level of evidence: III.

2

كتاب

Contributors

المؤلفون: Adams, David R., Adams, Stewart, Amin, Mina, Avashia-Khemka, Nidhi, Beck, Kristen M., Bhatia, Bhavnit K., Bhatia, Sravya Mallam, Bhutani, Tina, Braue, Jonathan A., Brodell, Robert T., Brodland, David G., Broussard-Steinberg, Candace, Callen, Jeffrey P., Camisa, Charles, Chehade, Ahmad, Chima, Margot, Clark, Richard A., Cline, Abigail, Cordoro, Kelly M., Cruz Ramón, Julio C., Davis, Loretta S., Feld, Salma de la, M.C. DeKlotz, Cynthia, Duprat, Gabrielle-Eugenie, Eaglstein, William H., Elston, Carly A., Elston, Dirk M., Emerson, Ashley N., Fabbro, Stephanie K., Feldman, Steven R., Ferris, Laura K., Foley, Kelly A., Forman, Seth B., Garofola, Craig, Gehlhausen, Jeffrey R., Gelfand, Joel M., Girardi, Michael, Goerge, Tobias, Gordon, Kenneth B., Greiling, Teri M., Grinich, Erin E., Grove, Daniel, Gupta, Aditya K., Haggstrom, Anita, Haley, Christopher T., Hall, Russell P., Hamzavi, Iltefat, Heffernan, Michael P., Helfrich, Yolanda R., Hessel, Adam B.

المصدر: Comprehensive Dermatologic Drug Therapy ; page vi-xii

الإتاحة: https://doi.org/10.1016/b978-0-323-61211-1.01002-0Test
https://api.elsevier.com/content/article/PII:B9780323612111010020?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:B9780323612111010020?httpAccept=text/plainTest

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3

دورية أكاديمية

Persistent cutaneous hyperpigmentation due to hydroxychloroquinone one year after therapy discontinuation

المؤلفون: Morrison, L Katie, Nordlund, James J, Heffernan, Michael P

المصدر: Dermatology Online Journal. 15(12)

وصف الملف: text/html

الوصول الحر: https://escholarship.org/uc/item/2t07q0nwTest

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4

دورية

Preoperative left shoulder elevation > 1 cm is predictive of severe postoperative shoulder imbalance in early onset idiopathic scoliosis patients treated with growth-friendly instrumentation

المؤلفون: Li, Ying, Yang, Daniel, Bergman, Rachel, Jha, Sahil, Casden, Michael, Smith, John T., Vitale, Michael, Heffernan, Michael

المصدر: Spine Deformity; September 2023, Vol. 11 Issue: 5 p1157-1167, 11p

مستخلص: Purpose: Prior research has demonstrated the influence of preoperative shoulder elevation (SE), proximal thoracic curve magnitude, and upper instrumented vertebra (UIV) on shoulder balance after PSF for AIS. Our purpose was to evaluate the impact of these factors on shoulder balance in early onset idiopathic scoliosis (EOIS) patients treated with growth-friendly instrumentation. Methods: This was a multicenter retrospective review. Children with EOIS treated with dual TGR, MCGR, or VEPTR and minimum 2-year follow-up were identified. Demographics and radiographic/surgical data were collected. Results: 145 patients met inclusion criteria: 74 had right SE (RSE), 49 left SE (LSE), and 22 even shoulders (EVEN) preoperatively. Mean follow-up was 5.3 years (range, 2.0–13.1 years). The LSE group had a larger pre-index mean main thoracic curve (p = 0.021) but no difference was observed between groups at the post-index or most recent timepoints. RSE patients with UIV of T2 were more likely to have balanced shoulders post-index than patients with UIV of T3 or T4 (p = 0.011). Conclusion: Preoperative LSE > 1.0 cm is predictive of shoulder imbalance ≥ 2 cm after insertion of TGR, MCGR, or VEPTR in children with EOIS. In patients with preoperative RSE, UIV of T2 resulted in a higher likelihood of balanced shoulders postoperatively.

5

دورية

Concave and convex growth do not differ over tethered vertebral segments, even with open tri-radiate cartilage

المؤلفون: Farivar, Daniel, Parent, Stefan, Miyanji, Firoz, Heffernan, Michael J., El-Hawary, Ron, Larson, A. Noelle, Andras, Lindsay M., Skaggs, David L.

المصدر: Spine Deformity; July 2023, Vol. 11 Issue: 4 p881-886, 6p

مستخلص: Purpose: To assess the following hypotheses related to vertebral body tethering (VBT): 1. VBT is associated with asymmetric (concave > convex) increases in height over the instrumented vertebra. 2. The instrumented Cobb angle improves following VBT surgery with growth. Methods: This is a retrospective case series of pediatric patients from a multicenter scoliosis registry treated with VBT between 2013 to 2021. Inclusion criteria: patients with standing radiographs at < 4 months and ≥ 2 years after surgery. Distances between the superior endplate of the UIV and the inferior endplate of the LIV were measured at the concave corner, mid-point, and convex corner of the endplates. The UIV-LIV angle was recorded. Subgroup analyses included comparing different Risser scores and tri-radiate cartilage (TRC) closed versus open using student t-tests. Results: 83 patients met inclusion criteria (92% female; age at time of surgery 12.5 ± 1.4 years) with mean follow-up time of 3.8 ± 1.4 years. Risser scores at surgery were: 0 (n = 33), 1 (n = 12), 2 (n = 10), 3 (n = 11), 4 (n = 12), and 5 (n = 5). Of the 33 Risser 0 patients, 17 had an open TRC, 16 had a closed TRC. The UIV-LIV distance at concave, middle, and convex points significantly increased from immediate post-op to final-follow-up for Risser 0 patients, but not for Risser 1–5 patients. Increases in UIV-LIV distance were not significantly different between concave, middle, and convex points for all groups. There was no significant improvement or worsening in UIV-LIV angle for any group. Conclusion: At a mean of 3.8 years following VBT, 33 Risser 0 patients demonstrated significant growth in the instrumented segment, though there was no difference between concave or convex growth, even for patients with open TRC.

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دورية

Minimalistic approach to enhanced recovery after pediatric scoliosis surgery

المؤلفون: Barnett, Scott A., Song, Bryant M., Bauer, Matthew, Nungesser, Matthew E., Leonardi, Claudia, Heffernan, Michael J.

المصدر: Spine Deformity; July 2023, Vol. 11 Issue: 4 p841-846, 6p

مستخلص: Purpose: Prior studies of enhanced recovery protocols (ERP) have been conducted at large institutions with abundant resources. These results may not apply at institutions with less resources directed to quality improvement efforts. The purpose of this study was to assess the value of a minimalistic enhanced recovery protocol in reducing length of stay (LOS) following PSF for adolescent idiopathic scoliosis. We hypothesized that accelerated transition to oral pain medications and mobilization alone could shorten hospital length of stay in the absence of a formal multimodal pain regimen. Methods: AIS patients aged 10–18 who underwent PSF at a tertiary pediatric hospital between January 1, 2014 and December 31, 2017 were reviewed. The study population was further narrowed to consecutive patients from a single surgeon’s practice that piloted the modified ERP. Reservation from key stakeholders regarding the feasibility of implementing widespread protocol change led to the minimal alterations made to the postoperative protocol following PSF. Patients were divided into either the Standard Recovery Protocol (SRP) or Enhanced Recovery Protocol (ERP). Primary variables analyzed were hospital LOS, complications, readmissions, and total narcotic requirement. Results: A total of 92 patients met inclusion criteria. SRP and ERP groups consisted of 44 (47.8%) and 48 (52.2%) patients. There was no difference between the two groups with regard to age, sex, and ASA score (p> 0.05). Fusion levels and EBL did not differ between treatment groups (p> 0.05). PCA pumps were discontinued later in the SRP group (39.5 ± 4.3 h) compared to the ERP group (17.4 ± 4.1 h, p< 0.0001). Narcotic requirement was similar between groups (p= 0.94) Patients in the SRP group had longer hospital stays than patients in the ERP group (p< 0.0001). 83% of the ERP group had LOS ≤ 3 days compared to 0% in the SRP group, whose mean LOS was 4.2 days. There was no difference in complications between the groups (2.2% vs 6.0%, p= 0.62). Readmission to the hospital within 30 days of surgery was rare in either group (2 SRP patients: 1 superior mesenteric artery syndrome, 1 bowel obstruction vs 0 ERP patients, p= 0.23). Conclusion: In this cohort, minor changes to the postoperative protocol following surgery for AIS led to a significant decrease in hospital length of stay. This minimalistic approach may ease implementation of an ERP in the setting of stakeholder apprehension.

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دورية أكاديمية

Features that define clinical severity of ulcerative pyoderma gangrenosum: a Delphi consensus study of experts and patients on behalf of the US Medical Dermatology Society

المصدر: British Journal of Dermatology ; volume 188, issue 4, page 566-568 ; ISSN 0007-0963 1365-2133

مصطلحات موضوعية: Dermatology

الإتاحة: https://doi.org/10.1093/bjd/ljac137Test
https://academic.oup.com/bjd/article-pdf/188/4/566/51960974/ljac137.pdfTest

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8

دورية أكاديمية

Degrees of Influence: The Politics of Honorary Degrees in the Universities of Oxford and Cambridge, 1900-2000

المؤلفون: Heffernan, Michael, Jons, Heike

المصدر: Minerva: A Review of Science, Learning and Policy. Dec 2007 45(4):389-416.

تمت مراجعته من قبل الزملاء: Y

Page Count: 28

الواصفات: Academic Degrees, Higher Education, Foreign Countries, Educational History, Educational Policy, Awards, Politics of Education, Educational Philosophy, Power Structure, Reputation, College Environment

مصطلحات جغرافية: United Kingdom (England)

مستخلص: The universities of Oxford and Cambridge had developed different attitudes towards the award of honorary degrees through the early and middle decades of the twentieth century. Recently, both have adopted a similar cautious and apolitical stance. This essay describes the role of honorary degrees in the production and reproduction of their cultural and intellectual authority of these two ancient universities.

Abstractor: As Provided