12 results on '"Spears JR"'
Search Results
2. Reperfusion Microvascular Ischemia After Prolonged Coronary Occlusion: Implications And Treatment With Local Supersaturated Oxygen Delivery
- Author
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Spears JR
- Subjects
lcsh:R5-920 ,capillaries ,ischemia ,lcsh:Medicine (General) ,oxygen ,plasma ,reperfusion - Abstract
James Richard Spears Cardiovascular Research Laboratory, Department of Medicine, Division of Cardiology, Beaumont Heart & Vascular Center, Dearborn, MI 48124, USACorrespondence: James Richard SpearsCardiovascular Research Laboratory, Department of Medicine, Division of Cardiology, Beaumont Heart & Vascular Center, 22060 Beech St, Suite 200, Dearborn, MI 48124, USATel +1 313-228-0505Fax +1 313-228-0508Email james.spears@beaumont.orgAbstract: Following a prolonged coronary arterial occlusion, heterogeneously scattered, focal regions of low erythrocyte flow are commonly found throughout the reperfused myocardium. Experimental studies have also demonstrated the presence of widespread, focally patchy regions of microvascular ischemia during reperfusion (RMI). However, the potential contribution of RMI to tissue viability and function has received little attention in the absence of practical clinical methods for its detection. In this review, the anatomic/functional basis of RMI is summarized, along with the evidence for its presence in reperfused myocardium. Advances in microcirculation research related to obstructive responses of vascular endothelial cells and blood elements to the effects of hypoxia and low shear stress are discussed, and a potential cycle of intensification of RMI from such responses and progressive loss of functional capillary density is presented. In capillaries with impaired erythrocyte flow, compensatory increases in the delivery of oxygen, because of its low solubility in plasma, are effective only at high partial pressures. As discussed herein, attenuation of the cycle with oxygen at hyperbaric levels in plasma is, very likely, responsible for improved tissue level perfusion noted experimentally. Observed clinical benefits from intracoronary SuperSaturated oxygen (SSO2) delivery, including infarct size reduction, can be attributed to attenuation of RMI with improvement in microvascular blood flow.Keywords: oxygen, ischemia, capillaries, reperfusion, plasma
- Published
- 2019
3. Bedlam : The Life & Mind of Earl Sedgwick
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Bobby Spears, Jr and Bobby Spears, Jr
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- Biographical fiction, Novels
- Abstract
For fans of Shameless and Girl interrupted — Bedlam is a crackling, satirical debut based on a horrifying true story about what happens when an asylum owner becomes a patient.Bedlam details the frustrating life of Earl Sedgwick, owner and operator of a mental institute. Earl grew up in the business and subsequently took it over despite his avowed hatred of how the business robbed him of his childhood. He runs on empty until he's triggered by a visit from his more successful friends, realizing his life has been placed in its own padded room since he took on the family business. The career that is providing everything he has and keeping him alive is ultimately killing him at the same time. The torture of watching people die and/or lose their minds is not a healthy existence, but it is all he has ever known, and like many people he yearns to do something else. Something more. But with his mental health failing and his addiction adding fuel to the fire, Earl is in no shape to change his life. Earl has to then decide what his next move will be. Bedlam takes us through a series of stories and anecdotes featuring the wild antics of patients, staff and their families, as Earl not only becomes an addict but is also losing his mind.
- Published
- 2022
4. Ultrasoft, highly deformable microgels
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Bachman, Haylee, primary, Brown, Ashley C., additional, Clarke, Kimberly C., additional, Dhada, Kabir S., additional, Douglas, Alison, additional, Hansen, Caroline E., additional, Herman, Emily, additional, Hyatt, John S., additional, Kodlekere, Purva, additional, Meng, Zhiyong, additional, Saxena, Shalini, additional, Spears Jr, Mark W., additional, Welsch, Nicole, additional, and Lyon, L. Andrew, additional
- Published
- 2015
- Full Text
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5. Church & Sport in Alabama.
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Spears Jr., Joseph C.
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CHURCH buildings ,PSYCHOLOGY of the clergy ,PSYCHOLOGY ,SPORTS ,THEORY ,EVALUATION of human services programs - Abstract
Can a Sports Ministry program positively impact the church's mission among its members? Previous research with commitment theory in psychology as it relates to sports and religious activity (2, 19) indicates that what benefits that church members get out of attending church activities will impact their frequency of attendance and commitment to their church. Sports activities have long been used as a tool to bring people into the church and increase fellowship and evangelism (11). To date, there has been little empirical research into the specific benefits of a sports ministry in the opinion of the church leaders who have sports activities in their church. [ABSTRACT FROM AUTHOR]
- Published
- 2018
6. Reperfusion Injury in Patients With Acute Myocardial Infarction: JACC Scientific Statement.
- Author
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Welt FGP, Batchelor W, Spears JR, Penna C, Pagliaro P, Ibanez B, Drakos SG, Dangas G, and Kapur NK
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- Humans, Myocardial Infarction physiopathology, Myocardial Reperfusion methods, ST Elevation Myocardial Infarction physiopathology, ST Elevation Myocardial Infarction therapy, Myocardial Reperfusion Injury physiopathology, Myocardial Reperfusion Injury etiology
- Abstract
Despite impressive improvements in the care of patients with ST-segment elevation myocardial infarction, mortality remains high. Reperfusion is necessary for myocardial salvage, but the abrupt return of flow sets off a cascade of injurious processes that can lead to further necrosis. This has been termed myocardial ischemia-reperfusion injury and is the subject of this review. The pathologic and molecular bases for myocardial ischemia-reperfusion injury are increasingly understood and include injury from reactive oxygen species, inflammation, calcium overload, endothelial dysfunction, and impaired microvascular flow. A variety of pharmacologic strategies have been developed that have worked well in preclinical models and some have shown promise in the clinical setting. In addition, there are newer mechanical approaches including mechanical unloading of the heart prior to reperfusion that are in current clinical trials., Competing Interests: Funding Support and Author Disclosures Dr Welt has served as a consultant to Xenter Inc and Faraday Pharmaceuticals. Dr Drakos has served as a consultant to Abbott Laboratories; and has received research support from Novartis. Dr Kapur has received consulting/speaker fees from Abbott, Abiomed, Boston Scientific, Edwards, Getinge, LivaNova, Teleflex, and Zoll; and has received institutional research grants from Abbott, Abiomed, Boston Scientific, Getinge, LivaNova, and Teleflex. All other authors have reported that they have no relationships relevant to contents of this paper to disclose., (Copyright © 2024 American College of Cardiology Foundation. All rights reserved.)
- Published
- 2024
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7. Characterization of the Epidemiology and Risk Factors for Hand Fractures in Patients Aged 1 to 19 Presenting to United States Emergency Departments: A Retrospective Study of 21,031 Cases.
- Author
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Albright JA, Rebello E, Kosinski LR, Patel DD, Spears JR, Gil JA, and Katarincic JA
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- Adolescent, Child, Emergency Service, Hospital, Female, Humans, Male, Pandemics, Retrospective Studies, Risk Factors, United States epidemiology, COVID-19 epidemiology, Fractures, Bone epidemiology, Fractures, Bone etiology, Hand Injuries epidemiology
- Abstract
Background: Hand fractures are among the most common injuries presenting in pediatric emergency departments (EDs) with incidence reported as high as 624 hand fractures per 100,000 person-years. If gone untreated, these injuries can lead to pain, loss of function, and psychological trauma. The purpose of this study was to identify risk factors and characterize pediatric hand fractures over a 5-year period., Methods: The National Electronic Injury Surveillance System (NEISS) was queried for all hand fractures in patients aged 1 to 19 years presenting to US EDs between 2016 and 2020. Incidence was calculated using US census data. Cases were retrospectively analyzed using age, location of the injury, sex, coronavirus disease-2019 (COVID-19) era, and etiology of injury. Bivariate logistic regression was used where appropriate., Results: A total of 21,031 pediatric hand fractures were identified, representing an estimated 565,833 pediatric hand fractures presenting to EDs between 2016 and 2020. The mean incidence of pediatric hand fractures was 138.3 fractures for 100,000 person-years [95% confidence interval (CI): 136.2-140.4], with a 39.2% decrease in incidence occurring between 2019 and 2020. It was found that 42.2% of the fractures were in patients aged 10 to 14. The incidence of hand fractures for males and females was 97.9 (95% CI: 96.2-99.7) and 40.4 (95% CI: 39.2-41.5), respectively, with the male rate peaking at age 14 and the female rate peaking at age 12. Age, sex, location of the injury, and injury during the COVID-19 pandemic were demonstrated to influence the frequency and etiology of the fracture., Conclusion: This study determined the incidence of pediatric hand fractures presenting to EDs across the United States. In addition, it identified risk factors for common hand fracture etiologies (sports-related, falling, crush, punching) and demonstrated the change in rates of different etiologies of pediatric hand fractures that presented to US EDs during the COVID-19 pandemic., Level of Evidence: Level III-retrospective comparative study., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2022
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8. Update on Cardioprotective Strategies for STEMI: Focus on Supersaturated Oxygen Delivery.
- Author
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Kloner RA, Creech JL, Stone GW, O'Neill WW, Burkhoff D, and Spears JR
- Abstract
Despite the fact that door-to-balloon times have been greatly reduced, the rates of death and the incidence of heart failure in patients with ST-segment elevation myocardial infarction (MI) have plateaued. There is still an unmet need to further reduce MI size in the reperfusion era. Most adjunctive therapies to enhance myocardial salvage have failed, but some have shown promise. Currently, the only adjunctive therapy in a pivotal trial that has demonstrated reductions in infarct size is localized delivery of supersaturated oxygen (SSO
2 ) therapy. This review provides background on prior infarct size reduction efforts. The authors describe the preclinical data that shows the effectiveness of SSO2 in reducing MI size, improving regional myocardial blood flow and cardiac function, and reducing adverse left ventricular remodeling-presumably by reducing patchy areas of residual ischemia within the reperfused risk zone. Potential mechanisms by which SSO2 is beneficial are described, including the delivery of high levels of dissolved oxygen through plasma to ischemic, but viable, vascular and myocardial cells, thus allowing their survival and function. The authors then describe the SSO2 clinical trials, demonstrating that in patients with anterior ST-segment elevation MI, SSO2 therapy safely and effectively reduces infarct size, improves cardiac function, and reduces adverse left ventricular remodeling., Competing Interests: Drs Kloner and Burkhoff have been consultants for ZOLL TherOx. Dr Creech is an employee of ZOLL TherOx. Drs. Stone and O’Neill have been consultants for ZOLL TherOx; and were involved in previous clinical trials with SSO2. Dr Spears was involved with preclinical studies with SSO2., (© 2021 The Authors.)- Published
- 2021
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9. Cardiac Catheterization Laboratory Volume Changes During COVID-19-Findings from a Cardiovascular Fellows Consortium.
- Author
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Kadavath S, Mohan J, Ashraf S, Kassier A, Hawwass D, Madan N, Salehi N, Bernardo M, Mawri S, Rehman KA, Ya'qoub L, Strobel A, Dixon SR, Siraj A, Messenger J, Spears JR, Lopez-Candales A, Madder R, Bailey SR, Alaswad K, Kim MC, Safian RD, and Alraies MC
- Subjects
- Betacoronavirus, COVID-19, Data Collection, Humans, Pandemics, SARS-CoV-2, Social Media, Cardiac Catheterization trends, Coronavirus Infections epidemiology, Pneumonia, Viral epidemiology
- Published
- 2020
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10. Quadriceps tendon autograft ACL reconstruction has less pivot shift laxity and lower failure rates than hamstring tendon autografts.
- Author
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Nyland J, Collis P, Huffstutler A, Sachdeva S, Spears JR, Greene J, and Caborn DNM
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- Anterior Cruciate Ligament Reconstruction adverse effects, Autografts, Graft Survival, Humans, Joint Instability etiology, Knee Joint surgery, Physical Examination, Tendons transplantation, Transplantation, Autologous, Treatment Failure, Anterior Cruciate Ligament Injuries surgery, Anterior Cruciate Ligament Reconstruction methods, Hamstring Tendons transplantation, Joint Instability diagnosis, Quadriceps Muscle transplantation
- Abstract
Purpose: Quadriceps tendon (QT) autograft ACL reconstruction was hypothesized to possess less anterior knee laxity, pivot shift laxity, and lower failure rates than hamstring tendon (HT) autografts., Methods: Terms "hamstring tendon autograft" and "ACL reconstruction" or "quadriceps tendon autograft" and "ACL reconstruction" were searched in Embase and PubMed. Inclusion criteria required that studies included patients treated for primary ACL injury with reconstruction using either a QT autograft (Group 1) or a HT autograft (Group 2) and instrumented anterior knee laxity assessment. Extracted information included surgical fixation method, graft type, graft thickness or diameter, single vs. double bundle surgical method, publication year, time between the index knee injury and surgery, % women, initial and final subject number, subject age, follow-up length, side-to-side anterior knee laxity difference, Lysholm Score, Subjective IKDC score, anterior knee laxity side-to-side difference grade, ipsilateral pivot shift laxity grade, and failure rate. The Methodological Index for Nonrandomized Studies was used to evaluate study methodological quality., Results: The QT group (Group 1) had 17 studies and the HT group (Group 2) had 61 studies. Overall, Group 2 had greater pivot shift laxity (OR 1.29, 95% CI 1.05-1.59, p = 0.005). Group 2 suspensory femoral fixation had greater pivot shift laxity (OR 1.26, 95% CI 1.01-1.58, p = 0.02) than Group 1 compression femoral fixation. Group 2 compression femoral fixation also had more anterior knee laxity (OR 1.25, 95% CI 1.03-1.52, p = 0.01) than Group 1 compression femoral fixation and higher failure rates based on initial (OR 1.69, 95% CI 1.18-2.4, p = 0.002) and final (OR 1.89, 95% CI 1.32-2.71, p = 0.0003) subject number. Failure rate for HT compression femoral fixation was greater than suspensory femoral fixation based on initial (OR 2.08, 95% CI 1.52-2.84, p < 0.0001) and final (OR 2.26, 95% CI 1.63-3.16, p < 0.0001) subject number., Conclusions: Overall, QT autografts had less pivot shift laxity and lower failure rates based on final subject number than HT autografts. Compression QT autograft femoral fixation had lower pivot shift laxity than suspensory HT autograft femoral fixation. Compression QT autograft femoral fixation had less anterior knee laxity and lower failure rates than compression HT autograft femoral fixation. Suspensory HT autograft femoral fixation had lower failure rates than compression HT autograft femoral fixation. Greater knee laxity and failure rates may be related to a combination of HT autograft diameter and configuration (tissue quality and dimensions, strands, bundles, and suturing method) variability and fixation mode., Level of Evidence: Level IV.
- Published
- 2020
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11. Cementless Tapered Femoral Stems for Total Hip Arthroplasty in Octogenarians.
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Riley SA, Spears JR, Smith LS, Mont MA, Elmallah RK, Cherian JJ, and Malkani AL
- Subjects
- Acetabulum surgery, Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Arthroplasty, Replacement, Hip adverse effects, Arthroplasty, Replacement, Hip mortality, Female, Femur surgery, Follow-Up Studies, Humans, Kentucky epidemiology, Male, Middle Aged, Postoperative Complications etiology, Postoperative Period, Retrospective Studies, Survival Rate, Treatment Outcome, Young Adult, Arthroplasty, Replacement, Hip instrumentation, Blood Transfusion statistics & numerical data, Hip Prosthesis, Postoperative Complications epidemiology, Reoperation statistics & numerical data
- Abstract
Background: The use of cementless femoral components has become the standard in younger patients due to increased implant survivorship and decreased loosening. However, it remains controversial whether these femoral stems can provide comparable results in elderly patients. Therefore, our purpose was to compare the (1) incidence of revisions; (2) clinical outcomes; (3) incidence of postoperative blood transfusions; and (4) differences in complications between the 2 cohorts., Methods: Seventy-four consecutive patients (78 hips) aged 80 years or older, who underwent primary total hip arthroplasty using a cementless, tapered, femoral stem were retrospectively compared with a matched cohort of 76 patients (78 hips) who were less than 80 years. Mean age was 83 years (range, 80-91 years) vs 59 years (range, 17-79 years) for the matched group. Minimum follow-up was 2 years. Revision rates, clinical outcomes using the Harris Hip Score, incidences of complications, and postoperative transfusion rates were evaluated., Results: In the octogenarian cohort, the aseptic survivorship was 99%, compared with 95% in the matched group. There were 2 aseptic loosenings (2.6%): 1 femoral implant loosening (1.3%) and 1 acetabular loosening, but only 1 revision was performed, as one of the patients declined revision surgery. In the matched cohort, there were 6 revisions (7.7%). There were no significant differences in revision rates between the 2 cohorts, and no significant differences in final Harris Hip Score scores. The incidence of blood transfusion in the study group was 42% vs 19% in control group (P < .01)., Conclusion: The use of cementless, tapered, femoral stems yielded excellent results in the octogenarian group, although adequate patient preoperative optimization is necessary given the significantly higher transfusion incidence., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2016
- Full Text
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12. Periarticular injection of liposomal bupivacaine in total knee arthroplasty.
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Webb BT, Spears JR, Smith LS, and Malkani AL
- Abstract
The purpose of this study was to determine whether the use of a periarticular injection using liposomal bupivacaine could decrease pain and improve outcomes after total knee arthroplasty. Fifty consecutive patients received no periarticular injections (group A). Another 50 consecutive patients received a periarticular injection of liposomal bupivacaine (group B). There were no differences in the groups with respect to gender, age, body mass index (BMI), or comorbidities. There was a significant reduction in the amount of narcotics used in the liposomal bupivacaine group (60.97-mg oral morphine equivalent vs 89.74 mg, P = 0.009). Patients in group B with a BMI <40 and a Charlson comorbidity index of 0-3 had decreased length of stay (2.64 vs 3.06 days, P = .004), narcotic use over 24-48 hours (110.66 vs 182.47 mg, P = .013), and narcotic use over 48-72 hours (49.61 vs. 112.65 mg, P = .004). In patients with a BMI <40 and comorbidity index of ≤3, periarticular injection using liposomal bupivacaine leads to earlier discharge along with decreased use of narcotics.
- Published
- 2015
- Full Text
- View/download PDF
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