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315 results on '"Belzberg, Allan"'

6. Early versus late surgical decompression for patients with acute traumatic central cord syndrome: a systematic review and meta-analysis

Author

Sattari, Shahab Aldin, Antar, Albert, Theodore, John N., Hersh, Andrew M., Al-Mistarehi, Abdel-Hameed, Davidar, A. Daniel, Weber-Levine, Carly, Azad, Tej D., Yang, Wuyang, Feghali, James, Xu, Risheng, Manbachi, Amir, Lubelski, Daniel, Bettegowda, Chetan, Chang, Louis, Witham, Timothy, Belzberg, Allan, and Theodore, Nicholas

Published
2024
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16. Redesigned Electrodes for Improved Intraoperative Nerve Conduction Studies during the Treatment of Peripheral Nerve Injuries.

Author

Riemann, Nathaniel, Coursen, Jack, Porras, Laura Elena, Sabogal, Bryan, Liang, Xin-Hua, Guaraca, Christian, Belzberg, Allan, Ringkamp, Matthias, Wu, Gang, Zhu, Lily, Weed, Samantha, and Miranda, Constanza

Subjects
PERIPHERAL nerve injuries, PERIPHERAL neuropathy, BIOLOGICAL models, RESEARCH funding, ERGONOMICS, ACTION potentials, NEUROSURGERY, PRODUCT design, IN vivo studies, INTRAOPERATIVE care, INTRAOPERATIVE monitoring, ANIMAL experimentation, ELECTRIC stimulation, MEDICAL artifacts, ELECTRODES, NERVE conduction studies
Abstract

Traumatic peripheral nerve injuries (PNI), present with symptoms ranging from pain to loss of motor and sensory function. Difficulties in intraoperative visual assessment of nerve functional status necessitate intraoperative nerve conduction studies (INCSs) by neurosurgeons and neurologists to determine the presence of functioning axons in the zone of a PNI. This process, also referred to as nerve "inching", uses a set of stimulating and recording electrode hooks to lift the injured nerve from the surrounding surgical field and to determine whether an electrical stimulus can travel through the zone of injury. However, confounding electrical signal artifacts can arise from the current workflow and electrode design, particularly from the mandatory lifting of the nerve, complicating the definitive assessment of nerve function and neurosurgical treatment decision-making. The objective of this study is to describe the design process and verification testing of our group's newly designed stimulating and recording electrodes that do not require the lifting or displacement of the injured nerve during INCSs. Ergonomic in vivo analysis of the device within a porcine model demonstrated successful intraoperative manipulation of the device, while quantitative nerve action potential (NAP) signal analysis with an ex vivo simulated "inching" procedure on healthy non-human primate nerve tissue demonstrated excellent reproducible recorded NAP fidelity and the absence of NAP signal artifacts at all points of recording. Lastly, electrode pullout force testing determined maximum forces of 0.43 N, 1.57 N, and 3.61 N required to remove the device from 2 mm, 5 mm, and 1 cm nerve models, respectively, which are well within established thresholds for nerve safety. These results suggest that these new electrodes can safely and successfully perform accurate PNI assessment without the presence of artifacts, with the potential to improve the INCS standard of care while remaining compatible with currently used neurosurgical technology, infrastructure, and clinical workflows. [ABSTRACT FROM AUTHOR]

Published
2024
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18. Impact of Upper Limb Motor Recovery on Functional Independence After Traumatic Low Cervical Spinal Cord Injury.

Author

Javeed, Saad, Zhang, Justin K., Greenberg, Jacob K., Botterbush, Kathleen, Benedict, Braeden, Plog, Benjamin, Gupta, Vivek P., Dibble, Christopher F., Khalifeh, Jawad M., Wen, Huacong, Chen, Yuying, Park, Yikyung, Belzberg, Allan, Tuffaha, Sami, Burks, Stephen Shelby, Levi, Allan D., Zager, Eric L., Faraji, Amir H., Mahan, Mark A., and Midha, Rajiv

Published
2024
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25. Telomere alterations in neurofibromatosis type 1-associated solid tumors

Author

Rodriguez, Fausto J., Graham, Mindy K., Brosnan-Cashman, Jacqueline A., Barber, John R., Davis, Christine, Vizcaino, M. Adelita, Palsgrove, Doreen N., Giannini, Caterina, Pekmezci, Melike, Dahiya, Sonika, Gokden, Murat, Noë, Michael, Wood, Laura D., Pratilas, Christine A., Morris, Carol D., Belzberg, Allan, Blakeley, Jaishri, and Heaphy, Christopher M.

Published
2019
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27. Consensus-Based Best Practice Guidelines for the Management of Spinal Deformity and Associated Tumors in Pediatric Neurofibromatosis Type 1: Screening and Surveillance, Surgical Intervention, and Medical Therapy.

Author

Xu, Amy L., Suresh, Krishna V., Gomez, Jaime A., Emans, John B., Larson, A. Noelle, Cahill, Patrick J., Andras, Lindsay M., White, Klane K., Miller, Daniel J., Murphy, Joshua S., Groves, Mari L., Belzberg, Allan J., Hwang, Steven W., Rosser, Tena L., Staedtke, Verena, Ullrich, Nicole J., Sato, Aimee A., Blakeley, Jaishri O., Schorry, Elizabeth K., and Gross, Andrea M.

Published
2023
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33. Treatment decisions and the use of MEK inhibitors for children with neurofibromatosis type 1-related plexiform neurofibromas.

Author

Armstrong, Amy E., Belzberg, Allan J., Crawford, John R., Hirbe, Angela C., and Wang, Zhihong J.

Subjects
*NEUROFIBROMA, *NEUROFIBROMATOSIS 1, *PERIPHERAL nerve tumors, *NEUROFIBROMATOSIS, *CHILD patients, *WATCHFUL waiting, *PROTEIN-tyrosine kinase inhibitors
Abstract

Neurofibromatosis type 1 (NF1), the most common tumor predisposition syndrome, occurs when NF1 gene variants result in loss of neurofibromin, a negative regulator of RAS activity. Plexiform neurofibromas (PN) are peripheral nerve sheath tumors that develop in patients with NF1 and are associated with substantial morbidity and for which, until recently, the only treatment was surgical resection. However, surgery carries several risks and a proportion of PN are considered inoperable. Understanding the genetic underpinnings of PN led to the investigation of targeted therapies as medical treatment options, and the MEK1/2 inhibitor selumetinib has shown promising efficacy in pediatric patients with NF1 and symptomatic, inoperable PN. In a phase I/II trial, most children (approximately 70%) achieved reduction in tumor volume accompanied by improvements in patient-reported outcomes (decreased tumor-related pain and improvements in quality of life, strength, and range of motion). Selumetinib is currently the only licensed medical therapy indicated for use in pediatric patients with symptomatic, inoperable NF1-PN, with approval based on the results of this pivotal clinical study. Several other MEK inhibitors (binimetinib, mirdametinib, trametinib) and the tyrosine kinase inhibitor cabozantinib are also being investigated as medical therapies for NF1-PN. Careful consideration of multiple aspects of both disease and treatments is vital to reduce morbidity and improve outcomes in patients with this complex and heterogeneous disease, and clinicians should be fully aware of the risks and benefits of available treatments. There is no single treatment pathway for patients with NF1-PN; surgery, watchful waiting, and/or medical treatment are options. Treatment should be individualized based on recommendations from a multidisciplinary team, considering the size and location of PN, effects on adjacent tissues, and patient and family preferences. This review outlines the treatment strategies currently available for patients with NF1-PN and the evidence supporting the use of MEK inhibitors, and discusses key considerations in clinical decision-making. [ABSTRACT FROM AUTHOR]

Published
2023
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38. Development and validation of a prediction model for outcomes after transaxillary first rib resection for neurogenic thoracic outlet syndrome following strict Society for Vascular Surgery diagnostic criteria.

Author

Ochuba, Arinze J., Mallela, Deepthi P., Feghali, James, Lubelski, Daniel, Belzberg, Allan J., Hicks, Caitlin W., Abularrage, Christopher J., and Lum, Ying Wei

Abstract

Neurogenic thoracic outlet syndrome (NTOS) is the most common form of thoracic outlet syndrome. However, NTOS has remained difficult to diagnose and treat successfully. The purpose of the present study was to generate a predictive clinical calculator for postoperative outcomes after first rib resection (FRR) for NTOS. We performed a retrospective review of patients who had undergone FRR for NTOS at a single tertiary care institution between 2016 and 2020. A multivariate stepwise logistic regression analysis was performed to assess the association of the percentage of improvement after FRR with the patient baseline characteristics, pertinent clinical characteristics, and diagnostic criteria set by the Society for Vascular Surgery. The primary outcome was subjective patient improvement after FRR. A prediction risk calculator was developed using backward stepwise multivariate logistic regression coefficients. Bootstrapping was used for internal validation. A total of 208 patients (22.2% male; mean age, 35.8 ± 12.8 years; median follow-up, 44.9 months) had undergone 243 FRRs. Of the 208 patients, 94.7% had had symptoms localized to the supraclavicular area, and 97.6% had had symptoms in the hand. All the patients had had positive symptoms reproduced by the elevated arm stress test and upper limb tension test. Another reasonably likely diagnosis was absent for all the patients. Of the 196 patients who had received a lidocaine injection, 180 (93.3%) had experienced improvement of NTOS symptoms. Of the 95 patients who had received a Botox injection, 82 (74.6%) had experienced improvement of NTOS symptoms. Receiver operating characteristic curve analysis was used to assess the model. The area under the curve for the backward stepwise multivariate logistic regression model was 0.8. The multivariate logistic regression analyses revealed that the significant predictors of worsened clinical outcomes included hand weakness (adjusted odds ratio [aOR], 4.28; 95% confidence interval [CI], 1.04-17.74), increasing age (aOR, 0.93; 95% CI, 0.88-0.99), workers' compensation or litigation case (aOR, 0.09; 95% CI, 0.01-0.82), and symptoms in the dominant hand (aOR, 0.20; 95% CI, 0.05-0.88). Using retrospective data from a single-institution database, we have developed a prediction calculator with moderate to high predictive ability, as demonstrated by an area under the curve of 0.8. The tool (available at: https://jhhntosriskcalculator.shinyapps.io/NTOS%5fcalc/) is an important adjunct to clinical decision-making that can offer patients and providers realistic and personalized expectations of the postoperative outcome after FRR for NTOS. The findings from the present study have reinforced the diagnostic criteria set by the Society for Vascular Surgery. The calculator could aid physicians in surgical planning, referrals, and counseling patients on whether to proceed with surgery. [ABSTRACT FROM AUTHOR]

Published
2023
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43. Management of neurofibromatosis type 1-associated plexiform neurofibromas.

Author

Fisher, Michael J, Blakeley, Jaishri O, Weiss, Brian D, Dombi, Eva, Ahlawat, Shivani, Akshintala, Srivandana, Belzberg, Allan J, Bornhorst, Miriam, Bredella, Miriam A, Cai, Wenli, Ferner, Rosalie E, Gross, Andrea M, Harris, Gordon J, Listernick, Robert, Ly, Ina, Martin, Staci, Mautner, Victor F, Salamon, Johannes M, Salerno, Kilian E, and Spinner, Robert J

Published
2022
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