Increasing patient-reported allergies are not associated with pain, functional outcomes, or satisfaction following medial patellofemoral ligament reconstruction: a retrospective comparative cohort study

( Andrew S. Bi ),( Dhruv S. Shankar ),( Kinjal D. Vasavada ),( Nina D. Fisher ),( Eric J. Strauss ),( Michael J. Alaia ),( Kirk A. Campbell ) 대한슬관절학회 2022 대한슬관절학회지 Vol.34 No.-

Background: Patient-reported allergies (PRAs) are often stigmatized as a potential nonmodifiable risk factor for increased pain and worse functional outcomes following surgery. However, there is a dearth of literature directly assessing the impact of PRAs on outcomes in sport surgeries such as medial patellofemoral ligament reconstruction (MPFLR). The purpose of our study was to determine whether PRAs were associated with worse outcomes following MPFLR. Methods: We conducted a retrospective review of patients who underwent MPFLR at our institution from 2011 to 2019. Patients were included if they had at least 12 months of follow-up. PRAs were obtained from preoperative medical assessments and categorized by drug class. Demographic and perioperative data were obtained from electronic medical records. Postoperative outcomes were measured using a telephone survey and included recurrent instability, Visual analog scale (VAS) for pain, VAS for sports, Kujala score, MPFL-Return to Sport after Injury (MPFL-RSI) score, and overall satisfaction score. Multiple linear regression was used to determine association between PRAs and outcome measures, and p-values less than 0.05 were considered significant. Results: The cohort included 141 MPFLR. Most patients were female (98, 70%) with an average age of 25 years (range 12-56 years). Average follow-up time was 47 months. Forty-seven patients (33%) reported at least one PRA. There were no significant differences in postoperative pain, functional outcomes, satisfaction, or return to sport between patients with or without PRAs (all p > 0.05). Absence of antibiotic PRAs was predictive of higher VAS (p < 0.007), but there were no other differences. There were no significant differences in outcomes between patients without PRAs, PRAs without a concomitant psychiatric disorder, or PRAs with a concomitant psychiatric disorder (all p > 0.05). Conclusions: In conclusion, PRAs with or without concomitant psychiatric diagnoses are not associated with worse postoperative pain, functional outcomes, or satisfaction following MPFLR with allograft, dispelling common misconceptions that increased number of allergies or psychiatric diagnoses lead to inferior surgical outcomes. Presence of antibiotic allergies was associated with lower VAS postoperative pain score. Future research should investigate the relationship between PRAs and other surgeries in the field of sports medicine.

Crossed Renal Ectopia and Aorto-Occlusive Disease: A Management Strategy

Eugene Ng,Ian Campbell,Andrew MTL Choong,Nigel Dunglison,Maged Aziz 대한흉부외과학회 2015 Journal of Chest Surgery (J Chest Surg) Vol.48 No.5

We present a rare case of a patient with aortoiliac occlusive disease on the background of type A crossed renal ectopia, for whom open surgical intervention was required. Aortic exposure in patients with concomitant crossed renal ectopia can present technical challenges to the vascular surgeon. The knowledge of variations in the ectopic renal blood supply is of paramount importance when performing surgery to treat this condition and affects the choice of surgical exposure. We present and discuss the operative details of our patient and outline an approach to this subset of patients.

What Is the Effect of Body Mass Index on Subjective Outcome Following Vaginal Hysterectomy for Prolapse?

Thomas Gray,John Money-Taylor,Weiguang Li,Andrew G Farkas,Patrick C. Campbell,Stephen C. Radley 대한배뇨장애요실금학회 2019 International Neurourology Journal Vol.23 No.2

Purpose: Obesity is a significant risk factor for pelvic organ prolapse (POP), but the effects of obesity on outcomes of surgery for POP are poorly understood. The aim of this study was to assess the relationship between POP symptomatology, subjective outcomes of surgery and body mass index (BMI) in women undergoing vaginal hysterectomy for POP. Methods: Pre- and postoperative data from a validated pelvic floor questionnaire (electronic Personal Assessment Questionnaire- Pelvic Floor) were collected prospectively from 60 women undergoing vaginal hysterectomy for POP. Of these, 20 were normal weight (BMI 18.5–24.9 kg/m2), 20 were overweight (BMI 25–29.9 kg/m2), and 20 were women with obesity (BMI 30– 34.9 kg/m2). The relationship between BMI and symptom scores for prolapse, impact on vaginal symptoms on quality of life (VS-QoL) and ‘overall change in condition’ was assessed. Pre- and postoperative symptom scores were compared using repeated mixed analysis of variance test for BMI as a categorical variable (normal, overweight, and obese). Spearman rank order correlation test was carried out to evaluate BMI as a continuous variable. All women underwent vaginal hysterectomy using a standardized technique. Results: Overall, 93% of women reported improvement in their condition. The main finding was that ‘overall change in condition’ was negatively correlated with increasing BMI (rs=-0.324, P=0.028). Irrespective of BMI, significant improvements were observed in symptoms of prolapse and VS-QoL at 3-month postoperation. Conclusions: With increasing BMI, women are likely to report lower levels of satisfaction following prolapse surgery, despite reporting equivalent improvements in symptoms. BMI is known to affect how individuals perceive their general health and well-being with obese individuals reporting poorer levels of subjective health status. Women with obesity may perceive change in their condition after prolapse surgery differently to women of normal weight. Reduction of weight prior to prolapse surgery could be considered in obese women to improve subjective outcomes of surgery.

Comparison of Efficacy and Safety of Ombitasvir/Paritaprevir/ Ritonavir and Dasabuvir ± Ribavirin between Asian and Western HCV GT1b-Infected Patients

( Lai Wei ),( Yan Luo ),( Wang-long Chuang ),( Seung Woon Paik ),( Ming-lung Yu ),( Linda M Fredrick ),( Andrew Campbell ),( Roger Trinh ),( Jeffrey Enejosa ),( Nancy S Shulman ),( Jeong Heo ),( Nilou 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: ONYX-I and ONYX-II are Phase 3 studies exploring the PK, safety, and efficacy of the 3-DAA ± ribavirin regimen in a HCV GT1b-infected Asian population. Comparable PK exposures of the 3-DAA regimen between the Asian and predominantly Caucasian (thereafter referred to as “Western”) HCV GT1-infected patients in other studies have been published. Methods: We compared the safety/efficacy profiles of the 3-DAA regimen (+ ribavirin for patients with compensated cirrhosis) in Asian patients in ONYX-I and -II Phase 3 studies conducted in China, Taiwan, and South Korea with Western patients enrolled in PEARL-II (treatment-experienced), PEARL-III (treatment-naive), and TURQUOISE-II (compensated cirrhosis) Phase 3 studies conducted exclusively in North America, Europe, and Australia. Results: Among treatment-naive non-cirrhotic patients, sustained virologic response at post treatment week 12 (SVR12) was achieved by 99.5% (183/184; 95% CI 97.0-99.9) of Asian patients compared with 99.0% (207/209; 95% CI 97.7-100) of Western patients (GT1b). In non-cirrhotic treatment-experienced patients, SVR12 was achieved by 100% (141/141; 95% CI 97.4-100) of Asian patients and 100% (91/91; 95% CI 95.9-100) of Western patients (GT1b). Among cirrhotic patients, SVR12 was achieved by 100% (104/104; 95% CI 96.4-100) of Asian patients compared with 98.5% (67/68; 95% CI 95.3-100) of Western patients (GT1a and -1b-infected patients). The majority of Asian and Western patients with or without cirrhosis had at least 1 treatment-emergent adverse event (TEAE). A low percentage of Asian and Western patients (<4%) experienced serious TEAEs. TEAEs leading to treatment discontinuation, in both Asian and Western patients, were rare. No patients without cirrhosis and 1 subject with cirrhosis discontinued treatment due to a TEAE. Only 1 death occurred across the studies, which was not due to a TEAE. Conclusions: The safety/efficacy profiles were consistent between the Asian and Western HCV GT1b-infected patients treated with OBV+PTV/r + DSV.

Phototactic guidance of a tissue-engineered soft-robotic ray

Park, Sung-Jin,Gazzola, Mattia,Park, Kyung Soo,Park, Shirley,Di Santo, Valentina,Blevins, Erin L.,Lind, Johan U.,Campbell, Patrick H.,Dauth, Stephanie,Capulli, Andrew K.,Pasqualini, Francesco S.,Ahn, American Association for the Advancement of Scienc 2016 Science Vol.353 No.6295

<P>Inspired by the relatively simple morphological blueprint provided by batoid fish such as stingrays and skates, we created a biohybrid system that enables an artificial animal-a tissue-engineered ray-to swim and phototactically follow a light cue. By patterning dissociated rat cardiomyocytes on an elastomeric body enclosing a microfabricated gold skeleton, we replicated fish morphology at 1/10 scale and captured basic fin deflection patterns of batoid fish. Optogenetics allows for phototactic guidance, steering, and turning maneuvers. Optical stimulation induced sequential muscle activation via serpentine-patterned muscle circuits, leading to coordinated undulatory swimming. The speed and direction of the ray was controlled by modulating light frequency and by independently eliciting right and left fins, allowing the biohybrid machine to maneuver through an obstacle course.</P>