Study Design-Longitudinal radiographic study of patients with progressive idiopathic scoliosis.Objective-To determine the relative contributions of vertebral and disc wedging to the increase in Cobb angle during 3 phases of adolescent skeletal growth and maturation.Summary of Background Data-Both disc wedging and vertebral body wedging are found in progressive scoliosis, but their relative contribution to curve progression over time is unknown. Which occurs first is important for understanding how scoliosis progresses and for developing methods to halt progression. Previous studies have not properly identified maturity and provide conflicting results.Methods-Eighteen girls were followed through their adolescent growth spurt with serial spine and hand skeletal age radiographs. Each Cobb angle was divided into disc wedge angles and vertebral wedge angles. The corresponding hand radiographs provided a measure of maturity level, the Digital Skeletal Age (DSA). The disc versus bone contributions to the Cobb angle were then compared during 3 growth phases: prior to the growth spurt, during the growth spurt and after the growth spurt. Significance of relative changes was assessed with the Wilcoxon two-sided mean rank test.Results-Prior to the growth spurt, there was no difference in relative contributions of the disc and the bone (3° vs 0°, p=0.38) to curve progression. During the growth spurt, the mean disc component progressed significantly more than that of the vertebrae (15° vs 0°, p=0.0002). This reversed following the growth spurt with the vertebral component progressing more than the disc (10° vs 0°, p=0.01).Conclusion-Adolescent idiopathic scoliosis initially increases through disc wedging during the rapid growth spurt with progressive vertebral wedging occurring later.
Strikingly, more than half of admissions for intrathoracic stomach were emergent. Emergent admissions had higher mortality, longer LOS, and higher cost than elective admissions. These data support consideration of early elective repair.
Study Design:Observational study.Objectives:To determine the publication rate of podium presentations from the North American Spine Society (NASS) annual meetings from the years 2009 to 2011.Methods:In April 2015, a PubMed search was conducted using titles from the paper presentations as well as the authors. Of the search results that were found, the specific scientific journal in which the article was published was recorded. We analyzed further the top 4 destination journals and trends in publications in these journals over the study period. No study funding was obtained for this research, and there are no potential conflicts of interest or associated biases.Results:Over the study period, 671 paper presentations were available and 342 were published (51% publication rate). The highest publication rate was from the 2011 annual meeting, with 55.3%, and the lowest year was 2010, with a rate of 46.43%. Spine (32.75%), The Spine Journal (19.01%), Journal of Neurosurgery Spine (7.31%), and European Spine Journal (6.73%) were the top 4 destination journals. Over the study period, we found a significant decrease in publication rate in Spine (P = .001) and a significant increase in publication rate in The Spine Journal (P = .003). There were no significant difference in publication rate over the study period in Journal of Neurosurgery Spine (P = .15) or European Spine Journal (P = .23).Conclusions:This is the first study to our knowledge evaluating the publication rate of podium presentations from recent North American Spine Society annual meetings. We found an overall publication rate of 51%.
27 28Background: Postnatal development of the microbiota in early life influences immunity, 29 metabolism, neurodevelopment and long-term infant health. Microbiome development occurs at 30 multiple body sites, each with distinct community compositions and functions. Associations 31 between microbiota at multiple sites represent an unexplored influence on the infant 32 microbiome. Here, we examined co-occurrence patterns of gut and respiratory microbiota in 33 pre-and full-term infants over the first year of life, a period critical to neonatal development and 34 risk of respiratory diseases. 35Results: Gut and respiratory microbiota collected as longitudinal rectal, throat and nasal 36 samples from 38 pre-term and 44 full-term infants were first clustered into community state 37 types (CSTs) on the basis of their composition. Multiple methods were used to relate the 38 occurrence of CSTs to several measures of infant maturity, including gestational age (GA) at 39 birth, week of life (WOL), and post menstrual age (PMA: equal to GA plus WOL). Manifestation 40 of CSTs followed one of three patterns with respect to infant maturity. First, chronological: 41 independent of infant maturity (GA) at birth, and strongly associated with post-natal age (WOL). 42 Second, idiosyncratic: primarily dependent on maturity (GA) at birth, with persistent differences 43 in CST occurrence between pre-and full-term infants through the first year of life. Third, 44 convergent: CSTs appear earlier in infants with greater maturity (GA) at birth, but after a 45 sufficient post-natal interval their occurrence in pre-term infants reaches parity with full-term 46 infants. The composition of CSTs was highly dissimilar between different body sites, but the 47 CST of any one body site was highly predictive of the CSTs at other body sites. There were 48 significant associations between the abundance of individual taxa at each body site and the 49
Background and Objectives:While combination antiretroviral therapy (cART) has dramatically increased the life expectancy of people with HIV (PWH), nearly 50% develop HIV-associated neurocognitive disorders (HAND)1. This may be due to previously uncontrolled HIV viral replication, immune activation maintained by residual viral replication2 or activation from other sources3, 4, or cART-associated neurotoxicity5. The aim of this study was to determine the effect of cART on cognition and neuroimaging biomarkers markers in people with HIV (PWH) before and after initiation of cART compared to HIV negative controls (HC) and HIV elite controllers (EC) who remain untreated.Methods:We recruited three groups of participants from the University of Rochester, McGovern Medical School and SUNY Upstate Medical University: 1) ART-treatment-naïve PWH; 2) age-matched HC; and 3) EC. Participants underwent brain MRI and clinical and neuropsychological assessments at baseline, one year, and two years. PWH were also assessed 12 weeks after initiating cART. Volumetric analysis and fractal dimensionality (FD) were calculated for cortical and subcortical regions. Mixed effect regressions examined the effect of group and imaging variables on cognition.Results:We enrolled 47 PWH, 58 HC, and 10 EC. At baseline, PWH had worse cognition and lower cortical volumes than HC. Cognition improved following initiation of cART and remained stable over time. Greater cortical thickness was associated with better cognition at baseline; greater FD of parietal, temporal and occipital lobes was associated with better cognition at baseline and longitudinally. At baseline, EC had worse cognition, lower cortical thickness and lower FD in all four lobes and caudate than PWH and HC. Greater cortical thickness, hippocampal volumes and FD of frontal, temporal and occipital lobes were associated with better cognition longitudinally.Conclusions:Initiation of cART in PWH is associated with improvement in brain structure and cognition. However, significant differences persist over time compared to HC. Similar trends in EC suggest that results are due to HIV infection rather than treatment. Stronger associations between cognition and FD suggest this imaging metric may be a more sensitive marker of neuronal injury than cortical thickness and volumetric measures.
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