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3. Surgery for multiple endocrine neoplasia type 1-related insulinoma

Author

van Beek, D. J., Nell, S., Verkooijen, H. M., Borel Rinkes, I. H. M., Valk, G. D., Vriens, M. R., Goudet, P., Vella, A., Donegan, D., Bartsch, D. K., Manoharan, J., Perrier, N. D., Christakis, I., Brandi, M. L., Zarnegar, R., Postma, E. L., Kebebew, E., Nockel, P., Brunaud, L., Pasternak, J. D., Kluijfhout, W. P., Sturgeon, C., Giri, S., Bonsing, B. A., van Eijck, C. H., van Goor, H., de Kleine, R. H. J., van Dijkum, E. J. Nieveen, Dejong, C. H. C., Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Clinical Genetics, and Department of Finance

Subjects
Male, endocrine system diseases, Kaplan-Meier Estimate, 0302 clinical medicine, Postoperative Complications, Multiple endocrine neoplasia, Child, Aged, 80 and over, Middle Aged, medicine.anatomical_structure, Treatment Outcome, 030220 oncology & carcinogenesis, HPB, Child, Preschool, Original Article, Female, Pancreas, hormones, hormone substitutes, and hormone antagonists, Adult, medicine.medical_specialty, endocrine system, Adolescent, Enucleation, Clinical Decision-Making, 030209 endocrinology & metabolism, Hypoglycemia, 03 medical and health sciences, Young Adult, Pancreatectomy, medicine, Multiple Endocrine Neoplasia Type 1, Humans, MEN1, General, Survival rate, Insulinoma, Aged, Retrospective Studies, business.industry, Original Articles, medicine.disease, Surgery, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Pancreatic Neoplasms, Localized disease, Neoplasm Recurrence, Local, business, Follow-Up Studies
Abstract

Background Insulinomas are found in 10–15 per cent of patients with multiple endocrine neoplasia type 1 (MEN1) and lead to life‐threatening hypoglycaemia. Surgical outcome and the optimal surgical strategy for MEN1‐related insulinoma are unknown. Methods Patients with MEN1‐related insulinomas were identified in 46 centres in Europe and North America between 1990 and 2016. Insulinomas were considered localized if the lesion was in the pancreatic head or body/tail. Patients with pancreatic neuroendocrine tumours throughout the pancreas were suspected of having multifocal insulinoma. The primary outcome was postoperative hypoglycaemia, defined as persistent hypoglycaemia, or recurrent hypoglycaemia caused by a new insulinoma or insulin‐producing liver metastases. Hypoglycaemia‐free survival was estimated by the Kaplan–Meier method. Results Ninety‐six patients underwent resection for MEN1‐related insulinoma. Sixty‐three and 33 patients had localized and multifocal insulinomas respectively. After a median follow‐up of 8 (range 1–22) years, one patient (1 per cent) had persistent disease and six (6 per cent) had developed recurrent disease, of whom four had a new insulinoma. The 10‐year hypoglycaemia‐free survival rate was 91 (95 per cent c.i. 80 to 96) per cent. Of those with localized disease, 46 patients underwent pancreatic resection and 17 enucleation. One of these patients had persistent disease and one developed recurrent insulinoma. Among patients with multifocal disease, three developed new insulinomas and two developed insulin‐producing liver metastases. Conclusion Surgery for MEN1‐related insulinoma is more successful than previously thought., In this cohort of 96 patients with resected multiple endocrine neoplasia 1 (MEN1)‐related insulinomas, seven patients (7 per cent) developed postoperative persistent or recurrent hypoglycaemia after a median follow‐up of 8 years. The 10‐year hypoglycaemia‐free survival rate was 91 (95 per cent c.i. 80 to 96) per cent. For patients with localized insulinoma, enucleation seems the preferred procedure. PPPD, pylorus‐preserving pancreatoduodenectomy. Outcomes good

Published
2020
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6. Surgery for multiple endocrine neoplasia type 1-related insulinoma: long-term outcomes in a large international cohort

Author

Beek, D J, primary, Nell, S, additional, Verkooijen, H M, additional, Borel Rinkes, I H M, additional, Valk, G D, additional, Vriens, M R, additional, Goudet, P, additional, Vella, A, additional, Donegan, D, additional, Bartsch, D K, additional, Manoharan, J, additional, Perrier, N D, additional, Christakis, I, additional, Brandi, M L, additional, Zarnegar, R, additional, Postma, E L, additional, Kebebew, E, additional, Nockel, P, additional, Brunaud, L, additional, Pasternak, J D, additional, Kluijfhout, W P, additional, Sturgeon, C, additional, Giri, S, additional, Bonsing, B A, additional, Eijck, C H, additional, Goor, H, additional, Kleine, R H J, additional, Dijkum, E J Nieveen, additional, and Dejong, C H C, additional

Published
2020
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10. Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Author

Sprague, S. (Sheila), Schemitsch, E.H. (Emil H.), Swiontkowski, M.F. (Marc ), Della Rocca, G.J. (Gregory J.), Jeray, K.J. (Kyle J.), Liew, S. (Susan), Slobogean, G.P. (Gerard P.), Bzovsky, S. (Sofia), Heels-Ansdell, D. (Diane), Zhou, Q. (Qi), Bhandari, M. (Mohit), Sprag, S. (Sheila), Devereaux, P.J., Guyatt, G.H. (Gordon), Heetveld, M.J. (Martin J.), Richardson, M. (Martin), Thabane, L. (Lehana), Tornetta III, P. (Paul), Walter, S.D. (Stephen D.), McKay, P. (Paula), Scott, T. (Taryn), Garibaldi, A. (Alisha), Viveiros, H. (Helena), Swinton, M. (Marilyn), Gichuru, M. (Mark), Buckingham, L. (Lisa), Duraikannan, A. (Aravin), Maddock, D. (Deborah), Simunovic, N. (Nicole), Agel, J. (Julie), Lieshout, E.M.M. (Esther) van, Zielinski, S.M. (Stephanie), Rangan, A. (Amar), Hanusch, B.C. (Birgit C.), Kottam, L. (Lucksy), Clarkson, R. (Rachel), Haverlag, R. (Robert), McCormack, R. (Robert), Apostle, K. (Kelly), Boyer, D. (Dory), Moola, F. (Farhad), Perey, B. (Bertrand), Stone, T. (Trevor), Viskontas, D. (Darius), Lemke, H.M. (H. Michael), Zomar, M. (Mauri), Moon, K. (Karyn), Moon, R. (Raely), Oatt, A. (Amber), Buckley, R.E. (Richard E.), Duffy, P. (Paul), Korley, R. (Robert), Puloski, S. (Shannon), Powell, J. (James), Johnston, K. (Kelly), Carcary, K. (Kimberly), Lorenzo, M. (Melissa), McKercher, R. (Ross), Sanders, D. (David), MacLeod, M. (Mark), Lawendy, A.-R. (Abdel-Rahman), Tieszer, C. (Christina), Stephen, D. (David), Kreder, H. (Hans), Jenkinson, R. (Richard), Nousiainen, M. (Markku), Axelrod, T. (Terry), Murnaghan, J. (John), Nam, D. (Diane), Wadey, V. (Veronica), Yee, A. (Albert), Milner, K. (Katrine), Kunz, M. (Monica), Ghent, W. (Wesley), McKee, M.D. (Michael D.), Hall, J.A. (Jeremy A.), Nauth, A. (Aaron), Ahn, H. (Henry), Whelan, D.B. (Daniel B.), Vicente, M.R. (Milena R.), Wild, L.M. (Lisa M.), Khan, R.M. (Ryan M.), Hidy, J.T. (Jennifer T.), Coles, C. (Chad), Leighton, R. (Ross), Biddulph, M. (Michael), Johnston, D. (David), Glazebrook, M. (Mark), Alexander, D. (David), Coady, C. (Catherine), Dunbar, M. (Michael), Amirault, J.D. (J. David), Gross, M. (Michael), Oxner, W. (William), Reardon, G. (Gerald), Richardson, C.G. (C. Glen), Trenholm, J.A. (J. Andrew), Wong, I. (Ivan), Trask, K. (Kelly), MacDonald, S. (Shelley), Dobbin, G. (Gwendolyn), Bicknell, R. (Ryan), Yach, J. (Jeff), Bardana, D. (Davide), Wood, G. (Gavin), Harrison, M. (Mark), Yen, D. (David), Lambert, S. (Sue), Howells, F. (Fiona), Ward, A. (Angela), Zalzal, P. (Paul), Brien, H. (Heather), Naumetz, V. (V.), Weening, B. (Brad), Wai, E.K. (Eugene K.), Papp, S. (Steve), Gofton, W.T. (Wade T.), Liew, A. (Allen), Kingwell, S.P. (Stephen P.), Johnson, G. (Garth), O'Neil, J. (Joseph), Roffey, D.M. (Darren M.), Borsella, V. (Vivian), Avram, V. (Victoria), Oliver, T.M. (Todd M.), Jones, V. (Vicki), Vogt, M. (Michelle), Jones, C.B. (Clifford B.), Ringler, J.R. (James R.), Endres, T.J. (Terrence J.), Sietsema, D.L. (Debra L.), Walker, J.E. (Jane E.), Broderick, J.S. (J. Scott), Goetz, D.R. (David R.), Pace, T.B. (Thomas B.), Schaller, T.M. (Thomas M.), Porter, S.E. (Scott E.), Beckish, M.L. (Michael L.), Adams, J.D. (John D.), Barden, B.B. (Benjamin B.), Creek, A.T. (Aaron T.), Finley, S.H. (Stephen H.), Foret, J.L. (Jonathan L.), Gudger, G.K. (Garland K.), Gurich, R.W. (Richard W.), Hill, A.D. (Austin D.), Hollenbeck, S.M. (Steven M.), Jackson, L.T. (Lyle T.), Kruse, K.K. (Kevin K.), Lackey, W.G. (Wesley G.), Langan, J.W. (Justin W.), Lee, J. (Julia), Leffler, L.C. (Lauren C.), Miller, T.J. (Timothy J.), Murphy, R.L. (R. Lee), O'Malley, L.K. (Lawrence K.), Peters, M.E. (Melissa E.), Price, D.M. (Dustin M.), Tanksley, J.A. (John A.), Torres, E.T. (Erick T.), Watson, D.J. (Dylan J.), Watson, S.T. (Scott T.), Tanner, S.L. (Stephanie L.), Snider, R.G. (Rebecca G.), Nastoff, L.A. (Lauren A.), Bielby, S.A. (Shea A.), Teasdall, R.J. (Robert J.), Switzer, J.A. (Julie A.), Cole, P.A. (Peter A.), Anderson, S.A. (Sarah A.), Lafferty, P.M. (Paul M.), Li, M. (Mengnai), Ly, T.V. (Thuan V.), Marston, S.B. (Scott B.), Foley, A.L. (Amy L.), Vang, S. (Sandy), Wright, D.M. (David M.), Marcantonio, A.J. (Andrew J.), Kain, M.S.H. (Michael S.H.), Iorio, R. (Richard), Specht, L.M. (Lawrence M.), Tilzey, J.F. (John F.), Lobo, M.J. (Margaret J.), Garfi, J.S. (John S.), Vallier, H.A. (Heather A.), Dolenc, A. (Andrea), Breslin, M. (Mary), Prayson, M.J. (Michael J.), Laughlin, R. (Richard), Rubino, L.J. (L. Joseph), May, J. (Jedediah), Rieser, G.R. (Geoffrey Ryan), Dulaney-Cripe, L. (Liz), Gayton, C. (Chris), Shaer, J. (James), Schrickel, T. (Tyson), Hileman, B. (Barbara), Gorczyca, J.T. (John T.), Gross, J.M. (Jonathan M.), Humphrey, C.A. (Catherine A.), Kates, S. (Stephen), Ketz, J.P. (John P.), Noble, K. (Krista), McIntyre, A.W. (Allison W.), Pecorella, K. (Kaili), Davis, C.A. (Craig A.), Weinerman, S. (Stuart), Weingarten, P. (Peter), Stull, P. (Philip), Lindenbaum, S. (Stephen), Hewitt, M. (Michael), Schwappach, J. (John), Baker, J.K. (Janell K.), Rutherford, T. (Tori), Newman, H. (Heike), Lieberman, S. (Shane), Finn, E. (Erin), Robbins, K. (Kristin), Hurley, M. (Meghan), Lyle, L. (Lindsey), Mitchell, K. (Khalis), Browner, K. (Kieran), Whatley, E. (Erica), Payton, K. (Krystal), Reeves, C. (Christina), Cannada, L.K. (Lisa K.), Karges, D.E. (David E.), Dawson, S.A. (Sarah A.), Mehta, S. (Samir), Esterhai, J. (John), Ahn, J. (Jaimo), Donegan, D. (Derek), Horan, A.D. (Annamarie D.), Hesketh, P.J. (Patrick J.), Bannister, E.R. (Evan R.), Keeve, J.P. (Jonathan P.), Anderson, C.G. (Christopher G.), McDonald, M.D. (Michael D.), Hoffman, J.M. (Jodi M.), Tarkin, I. (Ivan), Siska, P. (Peter), Gruen, G. (Gary), Evans, A. (Andrew), Farrell, D.J. (Dana J.), Irrgang, J. (James), Luther, A. (Arlene), Cross, W.W. (William W.), Cass, J.R. (Joseph R.), Sems, S.A. (Stephen A.), Torchia, M.E. (Michael E.), Scrabeck, T. (Tyson), Jenkins, M. (Mark), Dumais, J. (Jules), Romero, A.W. (Amanda W.), Sagebien, C.A. (Carlos A.), Butler, M.S. (Mark S.), Monica, J.T. (James T.), Seuffert, P. (Patricia), Hsu, J.R. (Joseph R.), Stinner, D. (Daniel), Ficke, J. (James), Charlton, M. (Michael), Napierala, M. (Matthew), Fan, M. (Mary), Tannoury, C. (Chadi), Carlisle, H. (Hope), Silva, H. (Heather), Archdeacon, M. (Michael), Finnan, R. (Ryan), Le, T. (Toan), Wyrick, J. (John), Hess, S. (Shelley), Brennan, M.L. (Michael L.), Probe, R. (Robert), Kile, E. (Evelyn), Mills, K. (Kelli), Clipper, L. (Lydia), Yu, M. (Michelle), Erwin, K. (Katie), Horwitz, D. (Daniel), Strohecker, K. (Kent), Swenson, T.K. (Teresa K.), Schmidt, A.H. (Andrew H.), Westberg, J.R. (Jerald R.), Aurang, K. (Kamran), Zohman, G. (Gary), Peterson, B. (Brett), Huff, R.B. (Roger B.), Baele, J. (Joseph), Weber, T. (Timothy), Edison, M. (Matt), McBeth, J.C. (Jessica Cooper), Shively, K. (Karl), Ertl, J.P. (Janos P.), Mullis, B. (Brian), Parr, J.A. (J. Andrew), Worman, R. (Ripley), Frizzell, V. (Valda), Moore, M.M. (Molly M.), DePaolo, C.J. (Charles J.), Alosky, R. (Rachel), Shell, L.E. (Leslie E.), Hampton, L. (Lynne), Shepard, S. (Stephanie), Nanney, T. (Tracy), Cuento, C. (Claudine), Cantu, R.V. (Robert V.), Henderson, E.R. (Eric R.), Eickhoff, L.S. (Linda S.), Hammerberg, E.M. (E. Mark), Stahel, P. (Philip), Hak, D. (David), Mauffrey, C. (Cyril), Henderson, C. (Corey), Gissel, H. (Hannah), Gibula, D. (Douglas), Zamorano, D.P. (David P.), Tynan, M.C. (Martin C.), Pourmand, D. (Deeba), Lawson, D. (Deanna), Crist, B.D. (Brett D.), Murtha, Y.M. (Yvonne M.), Anderson, L.K. (Linda K.), Linehan, C. (Colleen), Pilling, L. (Lindsey), Lewis, C.G. (Courtland G.), Caminiti, S. (Stephanie), Sullivan, R.J. (Raymond J.), Roper, E. (Elizabeth), Obremskey, W. (William), Kregor, P. (Philip), Richards, J.E. (Justin E.), Stringfellow, K. (Kenya), Dohm, M.P. (Michael P.), Zellar, A. (Abby), Segers, M.J.M. (Michiel), Zijl, J.A.C. (Jacco A.C.), Verhoeven, B. (Bart), Smits, A.B. (Anke B.), De Vries, J.P.P.M. (Jean Paul P.M.), Fioole, B. (Bram), Van Der Hoeven, H. (Henk), Theunissen, E.B.M. (Evert B.M.), De Vries Reilingh, T.S. (Tammo S.), Govaert, L. (Lonneke), Wittich, P. (Philippe), De Brauw, M. (Maurits), Wille, J.C. (Jan), Go, P.M.N.Y.M. (Peter M.N.Y.M.), Ritchie, E.D. (Ewan D.), Wessel, R.N. (Ronald N.), Hammacher, E.R. (Eric), Visser, G.A. (Gijs A.), Stockmann, H. (Heyn), Silvis, R. (Rob), Snellen, J.P. (Jaap P.), Rijbroek, B. (Bram), Scheepers, J.J. (Joris J.), Vermeulen, E.G.J. (Erik G.J.), Siroen, M.P.C. (Michiel P.C.), Vuylsteke, R. (Ronald), Brom, H.L.F., Rijna, H., Rijcke, P.A.R. (Piet), Koppert, C.L. (Cees L.), Buijk, S.E. (Steven E.), Groenendijk, R.P.R. (Richard), Dawson, I. (Imro), Tetteroo, G.W.M. (Geert), Bruijninckx, M.M.M. (Milko), Doornebosch, P. (Pascal), Graaf, E.J.R. (Eelco) de, Elst, M. (Maarten) van der, Pol, C. (Carmen) van der, Riet, M. (Martijne) van 't, Karsten, T.M. (Thomas), Vries, M.R. (Mark) de, Stassen, L.P.S. (Laurents P.S.), Schep, N.W.L. (Niels), Ben Schmidt, G. (G.), Hoffman, W.H. (W. H.), Poolman, R.W. (Rudolf), Simons, M.P., Heijden, F.H.W.M. (Frank) van der, Willems, W.J. (Jaap), De Meulemeester, F.R.A.J. (Frank R.A.J.), Hart, C.P. (Cor P.) van der, Turckan, K. (Kahn), Festen, S. (Sebastiaan), Nies, F. (Frank) de, Out, N.J.M. (Nico J.M.), Bosma, J. (Jan), Kampen, A. (A.) van, Biert, J. (Jan), Van Vugt, A.B. (Arie B.), Edwards, M.J.R. (Michael J.R.), Blokhuis, T.J. (Taco J.), Frölke, J.P.M. (Jan Paul), Geeraedts, L.M.G. (Leo M.G.), Gardeniers, J.W.M. (Jean W.M.), Tan, E.C.T.H. (Edward C.T.H.), Poelhekke, L.M.S.J., De Waal Malefijt, M.C. (Maarten C.), Schreurs, B. (Bart), Roukema, G.R. (Gert), Josaputra, H.A. (Hong A.), Keller, P. (Paul), De Rooij, P.D. (Peter D.), Kuiken, H. (Hans), Boxma, H. (Han), Cleffken, B.I. (Berry), Liem, R. (Ronald), Rhemrev, S. (Steven), Bosman, C.H.R. (Coks H.R.), De Mol Van Otterloo, A. (Alexander), Hoogendoorn, J. (Jochem), Vries, A.C. (Alexander) de, Meylaerts, S.A.G. (Sven), Verhofstad, M.H.J. (Michiel), Meijer, J. (Joost), Van Egmond, T. (Teun), Van Der Brand, I. (Igor), Patka, P. (Peter), Eversdijk, M.G. (Martin), Peters, R. (Rolf), Hartog, D. (Dennis) den, Waes, O.J.F. (Oscar) van, Oprel, P.P. (Pim), Vis, H.M. (Harm) van der, Campo, M. (Martin), Verhagen, R. (Ronald), Albers, G.H.R. (G.H. Robert), Zurcher, A.W. (Arthur W.), Simmermacher, R.K.J., Van Mulken, J. (Jeroen), Wessem, K.J.P. van, Van Gaalen, S.M. (Steven M.), Leenen, L.P.H., Bronkhorst, M.W.G.A. (Maarten), Guicherit, O.R. (Onno R.), Goslings, J.C. (Carel), Ponsen, K.J. (Kees-jan), Bhatia, M. (Mahesh), Arora, V. (Vinod), Tyagi, V. (Vivek), Bedi, H. (Harvinder), Carr, A. (Ashley), Curry, H. (Hamish), Chia, A. (Andrew), Csongvay, S. (Steve), Donohue, C. (Craig), Doig, S. (Stephen), Edwards, E. (Elton), Etherington, G. (Greg), Esser, M. (Max), Gong, A. (Andrew), Jain, A. (Arvind), Li, D. (Doug), Miller, R. (Russell), Moaveni, A. (Ash), Russ, M. (Matthias), Ton, L. (Lu), Wang, O. (Otis), Dowrick, A. (Adam), Murdoch, Z. (Zoe), Sage, C. (Claire), Frihagen, F. (Frede), Clarke-Jenssen, J. (John), Hjorthaug, G. (Geir), Ianssen, T. (Torben), Amundsen, A. (Asgeir), Brattgjerd, J.E. (Jan Egil), Borch, T. (Tor), Bøe, B. (Berthe), Flatøy, B. (Bernhard), Hasselund, S. (Sondre), Haug, K.J. (Knut Jørgen), Hemlock, K. (Kim), Hoseth, T.M. (Tor Magne), Jomaas, G. (Geir), Kibsgård, T. (Thomas), Lona, T. (Tarjei), Moatshe, G. (Gilbert), Müller, O. (Oliver), Molund, M. (Marius), Nicolaisen, T. (Tor), Nilsen, F. (Fredrik), Rydinge, J. (Jonas), Smedsrud, M. (Morten), Stødle, A. (Are), Trommer, A. (Axel), Ugland, S. (Stein), Karlsten, A. (Anders), Ekås, G. (Guri), Vesterhus, E.B. (Elise Berg), Brekke, A.C. (Anne Christine), Gupta, A. (Ajay), Jain, N. (Neeraj), Khan, F. (Farah), Sharma, A. (Ateet), Sanghavi, A. (Amir), Trivedi, M. (Mittal), Rai, A. (Anil), Subash, (), Rai, K. (Kamal), Yadav, V. (Vineet), Singh, S. (Sanjay), Tetsworth, K. (Kevin), Donald, G. (Geoff), Weinrauch, P. (Patrick), Pincus, P. (Paul), Yang, S. (Steven), Halliday, B. (Brett), Gervais, T. (Trevor), Holt, M. (Michael), Flynn, A. (Annette), Prasad, A.S. (Amal Shankar), Mishra, V. (Vimlesh), Sundaresh, D.C. (D. C.), Khanna, A. (Angshuman), Cherian, J.J. (Joe Joseph), Olakkengil, D.J. (Davy J), Sharma, G. (Gaurav), Pirpiris, M. (Marinis), Love, D. (David), Bucknill, A. (Andrew), Farrugia, R.J. (Richard J), Pape, H.-C. (Hans-Christoph), Knobe, M. (Matthias), Pfeifer, R. (Roman), Hull, P. (Peter), Lewis, S. (Sophie), Evans, S. (Simone), Nanda, R. (Rajesh), Logishetty, R. (Rajanikanth), Anand, S. (Sanjeev), Bowler, C. (Carol), Dadi, A. (Akhil), Palla, N. (Naveen), Ganguly, U. (Utsav), Rai, B.S. (B. Sachidananda), Rajakumar, J. (Janakiraman), Jennings, A. (Andrew), Chuter, G. (Graham), Rose, G. (Glynis), Horner, G. (Gillian), Clark, C. (Callum), Eke, K. (Kate), Reed, M.R. (Mike), Inman, D. (Dominic), Herriott, C. (Chris), Dobb, C. (Christine), Sprague, S. (Sheila), Schemitsch, E.H. (Emil H.), Swiontkowski, M.F. (Marc ), Della Rocca, G.J. (Gregory J.), Jeray, K.J. (Kyle J.), Liew, S. (Susan), Slobogean, G.P. (Gerard P.), Bzovsky, S. (Sofia), Heels-Ansdell, D. (Diane), Zhou, Q. (Qi), Bhandari, M. (Mohit), Sprag, S. (Sheila), Devereaux, P.J., Guyatt, G.H. (Gordon), Heetveld, M.J. (Martin J.), Richardson, M. (Martin), Thabane, L. (Lehana), Tornetta III, P. (Paul), Walter, S.D. (Stephen D.), McKay, P. (Paula), Scott, T. (Taryn), Garibaldi, A. (Alisha), Viveiros, H. (Helena), Swinton, M. (Marilyn), Gichuru, M. (Mark), Buckingham, L. (Lisa), Duraikannan, A. (Aravin), Maddock, D. (Deborah), Simunovic, N. (Nicole), Agel, J. (Julie), Lieshout, E.M.M. (Esther) van, Zielinski, S.M. (Stephanie), Rangan, A. (Amar), Hanusch, B.C. (Birgit C.), Kottam, L. (Lucksy), Clarkson, R. (Rachel), Haverlag, R. (Robert), McCormack, R. (Robert), Apostle, K. (Kelly), Boyer, D. (Dory), Moola, F. (Farhad), Perey, B. (Bertrand), Stone, T. (Trevor), Viskontas, D. (Darius), Lemke, H.M. (H. Michael), Zomar, M. (Mauri), Moon, K. (Karyn), Moon, R. (Raely), Oatt, A. (Amber), Buckley, R.E. (Richard E.), Duffy, P. (Paul), Korley, R. (Robert), Puloski, S. (Shannon), Powell, J. (James), Johnston, K. (Kelly), Carcary, K. (Kimberly), Lorenzo, M. (Melissa), McKercher, R. (Ross), Sanders, D. (David), MacLeod, M. (Mark), Lawendy, A.-R. (Abdel-Rahman), Tieszer, C. (Christina), Stephen, D. (David), Kreder, H. (Hans), Jenkinson, R. (Richard), Nousiainen, M. (Markku), Axelrod, T. (Terry), Murnaghan, J. (John), Nam, D. (Diane), Wadey, V. (Veronica), Yee, A. (Albert), Milner, K. (Katrine), Kunz, M. (Monica), Ghent, W. (Wesley), McKee, M.D. (Michael D.), Hall, J.A. (Jeremy A.), Nauth, A. (Aaron), Ahn, H. (Henry), Whelan, D.B. (Daniel B.), Vicente, M.R. (Milena R.), Wild, L.M. (Lisa M.), Khan, R.M. (Ryan M.), Hidy, J.T. (Jennifer T.), Coles, C. (Chad), Leighton, R. (Ross), Biddulph, M. (Michael), Johnston, D. (David), Glazebrook, M. (Mark), Alexander, D. (David), Coady, C. (Catherine), Dunbar, M. (Michael), Amirault, J.D. (J. David), Gross, M. (Michael), Oxner, W. (William), Reardon, G. (Gerald), Richardson, C.G. (C. Glen), Trenholm, J.A. (J. Andrew), Wong, I. (Ivan), Trask, K. (Kelly), MacDonald, S. (Shelley), Dobbin, G. (Gwendolyn), Bicknell, R. (Ryan), Yach, J. (Jeff), Bardana, D. (Davide), Wood, G. (Gavin), Harrison, M. (Mark), Yen, D. (David), Lambert, S. (Sue), Howells, F. (Fiona), Ward, A. (Angela), Zalzal, P. (Paul), Brien, H. (Heather), Naumetz, V. (V.), Weening, B. (Brad), Wai, E.K. (Eugene K.), Papp, S. (Steve), Gofton, W.T. (Wade T.), Liew, A. (Allen), Kingwell, S.P. (Stephen P.), Johnson, G. (Garth), O'Neil, J. (Joseph), Roffey, D.M. (Darren M.), Borsella, V. (Vivian), Avram, V. (Victoria), Oliver, T.M. (Todd M.), Jones, V. (Vicki), Vogt, M. (Michelle), Jones, C.B. (Clifford B.), Ringler, J.R. (James R.), Endres, T.J. (Terrence J.), Sietsema, D.L. (Debra L.), Walker, J.E. (Jane E.), Broderick, J.S. (J. Scott), Goetz, D.R. (David R.), Pace, T.B. (Thomas B.), Schaller, T.M. (Thomas M.), Porter, S.E. (Scott E.), Beckish, M.L. (Michael L.), Adams, J.D. (John D.), Barden, B.B. (Benjamin B.), Creek, A.T. (Aaron T.), Finley, S.H. (Stephen H.), Foret, J.L. (Jonathan L.), Gudger, G.K. (Garland K.), Gurich, R.W. (Richard W.), Hill, A.D. (Austin D.), Hollenbeck, S.M. (Steven M.), Jackson, L.T. (Lyle T.), Kruse, K.K. (Kevin K.), Lackey, W.G. (Wesley G.), Langan, J.W. (Justin W.), Lee, J. (Julia), Leffler, L.C. (Lauren C.), Miller, T.J. (Timothy J.), Murphy, R.L. (R. Lee), O'Malley, L.K. (Lawrence K.), Peters, M.E. (Melissa E.), Price, D.M. (Dustin M.), Tanksley, J.A. (John A.), Torres, E.T. (Erick T.), Watson, D.J. (Dylan J.), Watson, S.T. (Scott T.), Tanner, S.L. (Stephanie L.), Snider, R.G. (Rebecca G.), Nastoff, L.A. (Lauren A.), Bielby, S.A. (Shea A.), Teasdall, R.J. (Robert J.), Switzer, J.A. (Julie A.), Cole, P.A. (Peter A.), Anderson, S.A. (Sarah A.), Lafferty, P.M. (Paul M.), Li, M. (Mengnai), Ly, T.V. (Thuan V.), Marston, S.B. (Scott B.), Foley, A.L. (Amy L.), Vang, S. (Sandy), Wright, D.M. (David M.), Marcantonio, A.J. (Andrew J.), Kain, M.S.H. (Michael S.H.), Iorio, R. (Richard), Specht, L.M. (Lawrence M.), Tilzey, J.F. (John F.), Lobo, M.J. (Margaret J.), Garfi, J.S. (John S.), Vallier, H.A. (Heather A.), Dolenc, A. (Andrea), Breslin, M. (Mary), Prayson, M.J. (Michael J.), Laughlin, R. (Richard), Rubino, L.J. (L. Joseph), May, J. (Jedediah), Rieser, G.R. (Geoffrey Ryan), Dulaney-Cripe, L. (Liz), Gayton, C. (Chris), Shaer, J. (James), Schrickel, T. (Tyson), Hileman, B. (Barbara), Gorczyca, J.T. (John T.), Gross, J.M. (Jonathan M.), Humphrey, C.A. (Catherine A.), Kates, S. (Stephen), Ketz, J.P. (John P.), Noble, K. (Krista), McIntyre, A.W. (Allison W.), Pecorella, K. (Kaili), Davis, C.A. (Craig A.), Weinerman, S. (Stuart), Weingarten, P. (Peter), Stull, P. (Philip), Lindenbaum, S. (Stephen), Hewitt, M. (Michael), Schwappach, J. (John), Baker, J.K. (Janell K.), Rutherford, T. (Tori), Newman, H. (Heike), Lieberman, S. (Shane), Finn, E. (Erin), Robbins, K. (Kristin), Hurley, M. (Meghan), Lyle, L. (Lindsey), Mitchell, K. (Khalis), Browner, K. (Kieran), Whatley, E. (Erica), Payton, K. (Krystal), Reeves, C. (Christina), Cannada, L.K. (Lisa K.), Karges, D.E. (David E.), Dawson, S.A. (Sarah A.), Mehta, S. (Samir), Esterhai, J. (John), Ahn, J. (Jaimo), Donegan, D. (Derek), Horan, A.D. (Annamarie D.), Hesketh, P.J. (Patrick J.), Bannister, E.R. (Evan R.), Keeve, J.P. (Jonathan P.), Anderson, C.G. (Christopher G.), McDonald, M.D. (Michael D.), Hoffman, J.M. (Jodi M.), Tarkin, I. (Ivan), Siska, P. (Peter), Gruen, G. (Gary), Evans, A. (Andrew), Farrell, D.J. (Dana J.), Irrgang, J. (James), Luther, A. (Arlene), Cross, W.W. (William W.), Cass, J.R. (Joseph R.), Sems, S.A. (Stephen A.), Torchia, M.E. (Michael E.), Scrabeck, T. (Tyson), Jenkins, M. (Mark), Dumais, J. (Jules), Romero, A.W. (Amanda W.), Sagebien, C.A. (Carlos A.), Butler, M.S. (Mark S.), Monica, J.T. (James T.), Seuffert, P. (Patricia), Hsu, J.R. (Joseph R.), Stinner, D. (Daniel), Ficke, J. (James), Charlton, M. (Michael), Napierala, M. (Matthew), Fan, M. (Mary), Tannoury, C. (Chadi), Carlisle, H. (Hope), Silva, H. (Heather), Archdeacon, M. (Michael), Finnan, R. (Ryan), Le, T. (Toan), Wyrick, J. (John), Hess, S. (Shelley), Brennan, M.L. (Michael L.), Probe, R. (Robert), Kile, E. (Evelyn), Mills, K. (Kelli), Clipper, L. (Lydia), Yu, M. (Michelle), Erwin, K. (Katie), Horwitz, D. (Daniel), Strohecker, K. (Kent), Swenson, T.K. (Teresa K.), Schmidt, A.H. (Andrew H.), Westberg, J.R. (Jerald R.), Aurang, K. (Kamran), Zohman, G. (Gary), Peterson, B. (Brett), Huff, R.B. (Roger B.), Baele, J. (Joseph), Weber, T. (Timothy), Edison, M. (Matt), McBeth, J.C. (Jessica Cooper), Shively, K. (Karl), Ertl, J.P. (Janos P.), Mullis, B. (Brian), Parr, J.A. (J. Andrew), Worman, R. (Ripley), Frizzell, V. (Valda), Moore, M.M. (Molly M.), DePaolo, C.J. (Charles J.), Alosky, R. (Rachel), Shell, L.E. (Leslie E.), Hampton, L. (Lynne), Shepard, S. (Stephanie), Nanney, T. (Tracy), Cuento, C. (Claudine), Cantu, R.V. (Robert V.), Henderson, E.R. (Eric R.), Eickhoff, L.S. (Linda S.), Hammerberg, E.M. (E. Mark), Stahel, P. (Philip), Hak, D. (David), Mauffrey, C. (Cyril), Henderson, C. (Corey), Gissel, H. (Hannah), Gibula, D. (Douglas), Zamorano, D.P. (David P.), Tynan, M.C. (Martin C.), Pourmand, D. (Deeba), Lawson, D. (Deanna), Crist, B.D. (Brett D.), Murtha, Y.M. (Yvonne M.), Anderson, L.K. (Linda K.), Linehan, C. (Colleen), Pilling, L. (Lindsey), Lewis, C.G. (Courtland G.), Caminiti, S. (Stephanie), Sullivan, R.J. (Raymond J.), Roper, E. (Elizabeth), Obremskey, W. (William), Kregor, P. (Philip), Richards, J.E. (Justin E.), Stringfellow, K. (Kenya), Dohm, M.P. (Michael P.), Zellar, A. (Abby), Segers, M.J.M. (Michiel), Zijl, J.A.C. (Jacco A.C.), Verhoeven, B. (Bart), Smits, A.B. (Anke B.), De Vries, J.P.P.M. (Jean Paul P.M.), Fioole, B. (Bram), Van Der Hoeven, H. (Henk), Theunissen, E.B.M. (Evert B.M.), De Vries Reilingh, T.S. (Tammo S.), Govaert, L. (Lonneke), Wittich, P. (Philippe), De Brauw, M. (Maurits), Wille, J.C. (Jan), Go, P.M.N.Y.M. (Peter M.N.Y.M.), Ritchie, E.D. (Ewan D.), Wessel, R.N. (Ronald N.), Hammacher, E.R. (Eric), Visser, G.A. (Gijs A.), Stockmann, H. (Heyn), Silvis, R. (Rob), Snellen, J.P. (Jaap P.), Rijbroek, B. (Bram), Scheepers, J.J. (Joris J.), Vermeulen, E.G.J. (Erik G.J.), Siroen, M.P.C. (Michiel P.C.), Vuylsteke, R. (Ronald), Brom, H.L.F., Rijna, H., Rijcke, P.A.R. (Piet), Koppert, C.L. (Cees L.), Buijk, S.E. (Steven E.), Groenendijk, R.P.R. (Richard), Dawson, I. (Imro), Tetteroo, G.W.M. (Geert), Bruijninckx, M.M.M. (Milko), Doornebosch, P. (Pascal), Graaf, E.J.R. (Eelco) de, Elst, M. (Maarten) van der, Pol, C. (Carmen) van der, Riet, M. (Martijne) van 't, Karsten, T.M. (Thomas), Vries, M.R. (Mark) de, Stassen, L.P.S. (Laurents P.S.), Schep, N.W.L. (Niels), Ben Schmidt, G. (G.), Hoffman, W.H. (W. H.), Poolman, R.W. (Rudolf), Simons, M.P., Heijden, F.H.W.M. (Frank) van der, Willems, W.J. (Jaap), De Meulemeester, F.R.A.J. (Frank R.A.J.), Hart, C.P. (Cor P.) van der, Turckan, K. (Kahn), Festen, S. (Sebastiaan), Nies, F. (Frank) de, Out, N.J.M. (Nico J.M.), Bosma, J. (Jan), Kampen, A. (A.) van, Biert, J. (Jan), Van Vugt, A.B. (Arie B.), Edwards, M.J.R. (Michael J.R.), Blokhuis, T.J. (Taco J.), Frölke, J.P.M. (Jan Paul), Geeraedts, L.M.G. (Leo M.G.), Gardeniers, J.W.M. (Jean W.M.), Tan, E.C.T.H. (Edward C.T.H.), Poelhekke, L.M.S.J., De Waal Malefijt, M.C. (Maarten C.), Schreurs, B. (Bart), Roukema, G.R. (Gert), Josaputra, H.A. (Hong A.), Keller, P. (Paul), De Rooij, P.D. (Peter D.), Kuiken, H. (Hans), Boxma, H. (Han), Cleffken, B.I. (Berry), Liem, R. (Ronald), Rhemrev, S. (Steven), Bosman, C.H.R. (Coks H.R.), De Mol Van Otterloo, A. (Alexander), Hoogendoorn, J. (Jochem), Vries, A.C. (Alexander) de, Meylaerts, S.A.G. (Sven), Verhofstad, M.H.J. (Michiel), Meijer, J. (Joost), Van Egmond, T. (Teun), Van Der Brand, I. (Igor), Patka, P. (Peter), Eversdijk, M.G. (Martin), Peters, R. (Rolf), Hartog, D. (Dennis) den, Waes, O.J.F. (Oscar) van, Oprel, P.P. (Pim), Vis, H.M. (Harm) van der, Campo, M. (Martin), Verhagen, R. (Ronald), Albers, G.H.R. (G.H. Robert), Zurcher, A.W. (Arthur W.), Simmermacher, R.K.J., Van Mulken, J. (Jeroen), Wessem, K.J.P. van, Van Gaalen, S.M. (Steven M.), Leenen, L.P.H., Bronkhorst, M.W.G.A. (Maarten), Guicherit, O.R. (Onno R.), Goslings, J.C. (Carel), Ponsen, K.J. (Kees-jan), Bhatia, M. (Mahesh), Arora, V. (Vinod), Tyagi, V. (Vivek), Bedi, H. (Harvinder), Carr, A. (Ashley), Curry, H. (Hamish), Chia, A. (Andrew), Csongvay, S. (Steve), Donohue, C. (Craig), Doig, S. (Stephen), Edwards, E. (Elton), Etherington, G. (Greg), Esser, M. (Max), Gong, A. (Andrew), Jain, A. (Arvind), Li, D. (Doug), Miller, R. (Russell), Moaveni, A. (Ash), Russ, M. (Matthias), Ton, L. (Lu), Wang, O. (Otis), Dowrick, A. (Adam), Murdoch, Z. (Zoe), Sage, C. (Claire), Frihagen, F. (Frede), Clarke-Jenssen, J. (John), Hjorthaug, G. (Geir), Ianssen, T. (Torben), Amundsen, A. (Asgeir), Brattgjerd, J.E. (Jan Egil), Borch, T. (Tor), Bøe, B. (Berthe), Flatøy, B. (Bernhard), Hasselund, S. (Sondre), Haug, K.J. (Knut Jørgen), Hemlock, K. (Kim), Hoseth, T.M. (Tor Magne), Jomaas, G. (Geir), Kibsgård, T. (Thomas), Lona, T. (Tarjei), Moatshe, G. (Gilbert), Müller, O. (Oliver), Molund, M. (Marius), Nicolaisen, T. (Tor), Nilsen, F. (Fredrik), Rydinge, J. (Jonas), Smedsrud, M. (Morten), Stødle, A. (Are), Trommer, A. (Axel), Ugland, S. (Stein), Karlsten, A. (Anders), Ekås, G. (Guri), Vesterhus, E.B. (Elise Berg), Brekke, A.C. (Anne Christine), Gupta, A. (Ajay), Jain, N. (Neeraj), Khan, F. (Farah), Sharma, A. (Ateet), Sanghavi, A. (Amir), Trivedi, M. (Mittal), Rai, A. (Anil), Subash, (), Rai, K. (Kamal), Yadav, V. (Vineet), Singh, S. (Sanjay), Tetsworth, K. (Kevin), Donald, G. (Geoff), Weinrauch, P. (Patrick), Pincus, P. (Paul), Yang, S. (Steven), Halliday, B. (Brett), Gervais, T. (Trevor), Holt, M. (Michael), Flynn, A. (Annette), Prasad, A.S. (Amal Shankar), Mishra, V. (Vimlesh), Sundaresh, D.C. (D. C.), Khanna, A. (Angshuman), Cherian, J.J. (Joe Joseph), Olakkengil, D.J. (Davy J), Sharma, G. (Gaurav), Pirpiris, M. (Marinis), Love, D. (David), Bucknill, A. (Andrew), Farrugia, R.J. (Richard J), Pape, H.-C. (Hans-Christoph), Knobe, M. (Matthias), Pfeifer, R. (Roman), Hull, P. (Peter), Lewis, S. (Sophie), Evans, S. (Simone), Nanda, R. (Rajesh), Logishetty, R. (Rajanikanth), Anand, S. (Sanjeev), Bowler, C. (Carol), Dadi, A. (Akhil), Palla, N. (Naveen), Ganguly, U. (Utsav), Rai, B.S. (B. Sachidananda), Rajakumar, J. (Janakiraman), Jennings, A. (Andrew), Chuter, G. (Graham), Rose, G. (Glynis), Horner, G. (Gillian), Clark, C. (Callum), Eke, K. (Kate), Reed, M.R. (Mike), Inman, D. (Dominic), Herriott, C. (Chris), and Dobb, C. (Christine)

Abstract

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (for

Published
2018
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12. Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial

Author

Nauth, A. (Aaron), Creek, A.T. (Aaron T.), Zellar, A. (Abby), Lawendy, A.-R. (Abdel-Rahman), Dowrick, A. (Adam), Gupta, A. (Ajay), Dadi, A. (Akhil), Kampen, A. (A.) van, Yee, A. (Albert), Vries, A.C. (Alexander) de, de Mol van Otterloo, A. (Alexander), Garibaldi, A. (Alisha), Liew, A. (Allen), McIntyre, A.W. (Allison W.), Prasad, A.S. (Amal Shankar), Romero, A.W. (Amanda W.), Rangan, A. (Amar), Oatt, A. (Amber), Sanghavi, A. (Amir), Foley, A.L. (Amy L.), Karlsten, A. (Anders), Dolenc, A. (Andrea), Bucknill, A. (Andrew), Chia, A. (Andrew), Evans, A. (Andrew), Gong, A. (Andrew), Schmidt, A.H. (Andrew H.), Marcantonio, A.J. (Andrew J.), Jennings, A. (Andrew), Ward, A. (Angela), Khanna, A. (Angshuman), Rai, A. (Anil), Smits, A.B. (Anke B.), Horan, A.D. (Annamarie D.), Brekke, A.C. (Anne Christine), Flynn, A. (Annette), Duraikannan, A. (Aravin), Stødle, A. (Are), van Vugt, A.B. (Arie B.), Luther, A. (Arlene), Zurcher, A.W. (Arthur W.), Jain, A. (Arvind), Amundsen, A. (Asgeir), Moaveni, A. (Ash), Carr, A. (Ashley), Sharma, A. (Ateet), Hill, A.D. (Austin D.), Trommer, A. (Axel), Rai, B.S. (B. Sachidananda), Hileman, B. (Barbara), Schreurs, B. (Bart), Verhoeven, B. (Bart), Barden, B.B. (Benjamin B.), Flatøy, B. (Bernhard), Cleffken, B.I. (Berry), Bøe, B. (Berthe), Perey, B. (Bertrand), Hanusch, B.C. (Birgit C.), Weening, B. (Brad), Fioole, B. (Bram), Rijbroek, B. (Bram), Crist, B.D. (Brett D.), Halliday, B. (Brett), Peterson, B. (Brett), Mullis, B. (Brian), Richardson, C.G. (C. Glen), Clark, C. (Callum), Sagebien, C.A. (Carlos A.), Pol, C. (Carmen) van der, Bowler, C. (Carol), Humphrey, C.A. (Catherine A.), Coady, C. (Catherine), Koppert, C.L. (Cees L.), Coles, C. (Chad), Tannoury, C. (Chadi), DePaolo, C.J. (Charles J.), Gayton, C. (Chris), Herriott, C. (Chris), Reeves, C. (Christina), Tieszer, C. (Christina), Dobb, C. (Christine), Anderson, C.G. (Christopher G.), Sage, C. (Claire), Cuento, C. (Claudine), Jones, C.B. (Clifford B.), Bosman, C.H.R. (Coks H.R.), Linehan, C. (Colleen), Hart, C.P. (Cor P.) van der, Henderson, C. (Corey), Lewis, C.G. (Courtland G.), Davis, C.A. (Craig A.), Donohue, C. (Craig), Mauffrey, C. (Cyril), Sundaresh, D.C. (D. C.), Farrell, D.J. (Dana J.), Whelan, D.B. (Daniel B.), Horwitz, D. (Daniel), Stinner, D. (Daniel), Viskontas, D. (Darius), Roffey, D.M. (Darren M.), Alexander, D. (David), Karges, D.E. (David E.), Hak, D. (David), Johnston, D. (David), Love, D. (David), Wright, D.M. (David M.), Zamorano, D.P. (David P.), Goetz, D.R. (David R.), Sanders, D. (David), Stephen, D. (David), Yen, D. (David), Bardana, D. (Davide), Olakkengil, D.J. (Davy J), Lawson, D. (Deanna), Maddock, D. (Deborah), Sietsema, D.L. (Debra L.), Pourmand, D. (Deeba), Hartog, D. (Dennis) den, Donegan, D. (Derek), Heels-Ansdell, D. (Diane), Nam, D. (Diane), Inman, D. (Dominic), Boyer, D. (Dory), Li, D. (Doug), Gibula, D. (Douglas), Price, D.M. (Dustin M.), Watson, D.J. (Dylan J.), Hammerberg, E.M. (E. Mark), Tan, E.T.C.H. (Edward T.C.H.), Graaf, E.J.R. (Eelco) de, Vesterhus, E.B. (Elise Berg), Roper, E. (Elizabeth), Edwards, E. (Elton), Schemitsch, E.H. (Emil), Hammacher, E.R. (Eric), Henderson, E.R. (Eric R.), Whatley, E. (Erica), Torres, E.T. (Erick T.), Vermeulen, E.G.J. (Erik G.J.), Finn, E. (Erin), Lieshout, E.M.M. (Esther) van, Wai, E.K. (Eugene K.), Bannister, E.R. (Evan R.), Kile, E. (Evelyn), Theunissen, E.B.M. (Evert B.M.), Ritchie, E.D. (Ewan D.), Khan, F. (Farah), Moola, F. (Farhad), Howells, F. (Fiona), Nies, F. (Frank) de, Heijden, F.H.W.M. (Frank) van der, de Meulemeester, F.R.A.J. (Frank R.A.J.), Frihagen, F. (Frede), Nilsen, F. (Fredrik), Schmidt, G.B. (G. Ben), Albers, G.H.R. (G.H. Robert), Gudger, G.K. (Garland K.), Johnson, G. (Garth), Gruen, G. (Gary), Zohman, G. (Gary), Sharma, G. (Gaurav), Wood, G. (Gavin), Tetteroo, G.W.M. (Geert), Hjorthaug, G. (Geir), Jomaas, G. (Geir), Donald, G. (Geoff), Rieser, G.R. (Geoffrey Ryan), Reardon, G. (Gerald), Slobogean, G.P. (Gerard P.), Roukema, G.R. (Gert), Visser, G.A. (Gijs A.), Moatshe, G. (Gilbert), Horner, G. (Gillian), Rose, G. (Glynis), Guyatt, G. (Gordon), Chuter, G. (Graham), Etherington, G. (Greg), Rocca, G.J.D. (Gregory J. Della), Ekås, G. (Guri), Dobbin, G. (Gwendolyn), Lemke, H.M. (H. Michael), Curry, H. (Hamish), Boxma, H. (Han), Gissel, H. (Hannah), Kreder, H. (Hans), Kuiken, H. (Hans), Brom, H.L.F., Pape, H.-C. (Hans-Christoph), Vis, H.M. (Harm) van der, Bedi, H. (Harvinder), Vallier, H.A. (Heather A.), Brien, H. (Heather), Silva, H. (Heather), Newman, H. (Heike), Viveiros, H. (Helena), van der Hoeven, H. (Henk), Ahn, H. (Henry), Johal, H. (Herman), Rijna, H., Stockmann, H. (Heyn), Josaputra, H.A. (Hong A.), Carlisle, H. (Hope), van der Brand, I. (Igor), Dawson, I. (Imro), Tarkin, I. (Ivan), Wong, I. (Ivan), Parr, J.A. (J. Andrew), Trenholm, J.A. (J. Andrew), Goslings, J.C. (Carel), Amirault, J.D. (J. David), Broderick, J.S. (J. Scott), Snellen, J.P. (Jaap P.), Zijl, J.A.C. (Jacco A.C.), Ahn, J. (Jaimo), Ficke, J. (James), Irrgang, J. (James), Powell, J. (James), Ringler, J.R. (James R.), Shaer, J. (James), Monica, J.T. (James T.), Biert, J. (Jan), Bosma, J. (Jan), Brattgjerd, J.E. (Jan Egil), Frölke, J.P.M. (Jan Paul), Wille, J.C. (Jan), Rajakumar, J. (Janakiraman), Walker, J.E. (Jane E.), Baker, J.K. (Janell K.), Ertl, J.P. (Janos P.), de Vries, J.P.P.M. (Jean Paul P.M.), Gardeniers, J.W.M. (Jean W.M.), May, J. (Jedediah), Yach, J. (Jeff), Hidy, J.T. (Jennifer T.), Westberg, J.R. (Jerald R.), Hall, J.A. (Jeremy A.), van Mulken, J. (Jeroen), McBeth, J.C. (Jessica Cooper), Hoogendoorn, J. (Jochem), Hoffman, J.M. (Jodi M.), Cherian, J.J. (Joe Joseph), Tanksley, J.A. (John A.), Clarke-Jenssen, J. (John), Adams, J.D. (John D.), Esterhai, J. (John), Tilzey, J.F. (John F.), Murnaghan, J. (John), Ketz, J.P. (John P.), Garfi, J.S. (John S.), Schwappach, J. (John), Gorczyca, J.T. (John T.), Wyrick, J. (John), Rydinge, J. (Jonas), Foret, J.L. (Jonathan L.), Gross, J.M. (Jonathan M.), Keeve, J.P. (Jonathan P.), Meijer, J. (Joost), Scheepers, J.J. (Joris J.), Baele, J. (Joseph), O'Neil, J. (Joseph), Cass, J.R. (Joseph R.), Hsu, J.R. (Joseph R.), Dumais, J. (Jules), Lee, J. (Julia), Switzer, J.A. (Julie A.), Agel, J. (Julie), Richards, J.E. (Justin E.), Langan, J.W. (Justin W.), Turckan, K. (Kahn), Pecorella, K. (Kaili), Rai, K. (Kamal), Aurang, K. (Kamran), Shively, K. (Karl), Wessem, K.J.P. van, Moon, K. (Karyn), Eke, K. (Kate), Erwin, K. (Katie), Milner, K. (Katrine), Ponsen, K.J. (Kees-jan), Mills, K. (Kelli), Apostle, K. (Kelly), Johnston, K. (Kelly), Trask, K. (Kelly), Strohecker, K. (Kent), Stringfellow, K. (Kenya), Kruse, K.K. (Kevin K.), Tetsworth, K. (Kevin), Mitchell, K. (Khalis), Browner, K. (Kieran), Hemlock, K. (Kim), Carcary, K. (Kimberly), Jørgen Haug, K. (Knut), Noble, K. (Krista), Robbins, K. (Kristin), Payton, K. (Krystal), Jeray, K.J. (Kyle J.), Rubino, L.J. (L. Joseph), Nastoff, L.A. (Lauren A.), Leffler, L.C. (Lauren C.), Stassen, L.P. (Laurents), O'Malley, L.K. (Lawrence K.), Specht, L.M. (Lawrence M.), Thabane, L. (Lehana), Geeraedts, L.M.G. (Leo M.G.), Shell, L.E. (Leslie E.), Anderson, L.K. (Linda K.), Eickhoff, L.S. (Linda S.), Lyle, L. (Lindsey), Pilling, L. (Lindsey), Buckingham, L. (Lisa), Cannada, L.K. (Lisa K.), Wild, L.M. (Lisa M.), Dulaney-Cripe, L. (Liz), Poelhekke, L.M.S.J., Govaert, L. (Lonneke), Ton, L. (Lu), Kottam, L. (Lucksy), Leenen, L.P.H. (Luke), Clipper, L. (Lydia), Jackson, L.T. (Lyle T.), Hampton, L. (Lynne), de Waal Malefijt, M.C. (Maarten C.), Simons, M.P., Elst, M. (Maarten) van der, Bronkhorst, M.W.G.A. (Maarten), Bhatia, M. (Mahesh), Swiontkowski, M.F. (Marc ), Lobo, M.J. (Margaret J.), Swinton, M. (Marilyn), Pirpiris, M. (Marinis), Molund, M. (Marius), Gichuru, M. (Mark), Glazebrook, M. (Mark), Harrison, M. (Mark), Jenkins, M. (Mark), MacLeod, M. (Mark), Vries, M.R. (Mark) de, Butler, M.S. (Mark S.), Nousiainen, M. (Markku), van ‘t Riet, M. (Martijne), Tynan, M.C. (Martin C.), Campo, M. (Martin), Eversdijk, M.G. (Martin), Heetveld, M.J. (Martin), Richardson, M. (Martin), Breslin, M. (Mary), Fan, M. (Mary), Edison, M. (Matt), Napierala, M. (Matthew), Knobe, M. (Matthias), Russ, M. (Matthias), Zomar, M. (Mauri), de Brauw, M. (Maurits), Esser, M. (Max), Hurley, M. (Meghan), Peters, M.E. (Melissa E.), Lorenzo, M. (Melissa), Li, M. (Mengnai), Archdeacon, M. (Michael), Biddulph, M. (Michael), Charlton, M. (Michael), McDonald, M.D. (Michael D.), McKee, M.D. (Michael D.), Dunbar, M. (Michael), Torchia, M.E. (Michael E.), Gross, M. (Michael), Hewitt, M. (Michael), Holt, M. (Michael), Prayson, M.J. (Michael J.), Edwards, M.J.R. (Michael), Beckish, M.L. (Michael L.), Brennan, M.L. (Michael L.), Dohm, M.P. (Michael P.), Kain, M.S.H. (Michael S.H.), Vogt, M. (Michelle), Yu, M. (Michelle), Verhofstad, M.H.J. (Michiel), Segers, M.J.M. (Michiel J.M.), Segers, M.J.M. (Michiel), Siroen, M.P.C. (Michiel P.C.), Reed, M.R. (Mike), Vicente, M.R. (Milena R.), Bruijninckx, M.M.M. (Milko), Trivedi, M. (Mittal), Bhandari, M. (Mohit), Moore, M.M. (Molly M.), Kunz, M. (Monica), Smedsrud, M. (Morten), Palla, N. (Naveen), Jain, N. (Neeraj), Out, N.J.M. (Nico J.M.), Simunovic, N. (Nicole), Schep, N.W.L. (Niels), Müller, O. (Oliver), Guicherit, O.R. (Onno R.), Waes, O.J.F. (Oscar) van, Wang, O. (Otis), Doornebosch, P. (Pascal), Seuffert, P. (Patricia), Hesketh, P.J. (Patrick J.), Weinrauch, P. (Patrick), Duffy, P. (Paul), Keller, P. (Paul), Lafferty, P.M. (Paul M.), Pincus, P. (Paul), Tornetta III, P. (Paul), Zalzal, P. (Paul), McKay, P. (Paula), Cole, P.A. (Peter A.), de Rooij, P.D. (Peter D.), Hull, P. (Peter), Go, P.M.N.Y.M. (Peter M.N.Y.M.), Patka, P. (Peter), Siska, P. (Peter), Weingarten, P. (Peter), Kregor, P. (Philip), Stahel, P. (Philip), Stull, P. (Philip), Wittich, P. (Philippe), Rijcke, P.A.R. (Piet), Oprel, P.P. (Pim), Devereaux, P.J. (P. J.), Zhou, Q. (Qi), Lee Murphy, R. (R.), Alosky, R. (Rachel), Clarkson, R. (Rachel), Moon, R. (Raely), Logishetty, R. (Rajanikanth), Nanda, R. (Rajesh), Sullivan, R.J. (Raymond J.), Snider, R.G. (Rebecca G.), Buckley, R.E. (Richard E.), Iorio, R. (Richard), Farrugia, R.J. (Richard J), Jenkinson, R. (Richard), Laughlin, R. (Richard), Groenendijk, R.P.R. (Richard), Gurich, R.W. (Richard W.), Worman, R. (Ripley), Silvis, R. (Rob), Haverlag, R. (Robert), Teasdall, R.J. (Robert J.), Korley, R. (Robert), McCormack, R. (Robert), Probe, R. (Robert), Cantu, R.V. (Robert V.), Huff, R.B. (Roger B.), Simmermacher, R.K.J., Peters, R. (Rolf), Pfeifer, R. (Roman), Liem, R. (Ronald), Wessel, R.N. (Ronald N.), Verhagen, R. (Ronald), Vuylsteke, R. (Ronald), Leighton, R. (Ross), McKercher, R. (Ross), Poolman, R.W. (Rudolf), Miller, R. (Russell), Bicknell, R. (Ryan), Finnan, R. (Ryan), Khan, R.M. (Ryan M.), Mehta, S. (Samir), Vang, S. (Sandy), Singh, S. (Sanjay), Anand, S. (Sanjeev), Anderson, S.A. (Sarah A.), Dawson, S.A. (Sarah A.), Marston, S.B. (Scott B.), Porter, S.E. (Scott E.), Watson, S.T. (Scott T.), Festen, S. (Sebastiaan), Lieberman, S. (Shane), Puloski, S. (Shannon), Bielby, S.A. (Shea A.), Sprague, S. (Sheila), Hess, S. (Shelley), MacDonald, S. (Shelley), Evans, S. (Simone), Bzovsky, S. (Sofia), Hasselund, S. (Sondre), Lewis, S. (Sophie), Ugland, S. (Stein), Caminiti, S. (Stephanie), Tanner, S.L. (Stephanie L.), Zielinski, S.M. (Stephanie), Shepard, S. (Stephanie), Sems, S.A. (Stephen A.), Walter, S.D. (Stephen D.), Doig, S. (Stephen), Finley, S.H. (Stephen H.), Kates, S. (Stephen), Lindenbaum, S. (Stephen), Kingwell, S.P. (Stephen P.), Csongvay, S. (Steve), Papp, S. (Steve), Buijk, S.E. (Steven E.), Rhemrev, S. (Steven), Hollenbeck, S.M. (Steven M.), van Gaalen, S.M. (Steven M.), Yang, S. (Steven), Weinerman, S. (Stuart), Subash, (), Lambert, S. (Sue), Liew, S. (Susan), Meylaerts, S.A.G. (Sven), Blokhuis, T.J. (Taco J.), de Vries Reilingh, T.S. (Tammo S.), Lona, T. (Tarjei), Scott, T. (Taryn), Swenson, T.K. (Teresa K.), Endres, T.J. (Terrence J.), Axelrod, T. (Terry), van Egmond, T. (Teun), Pace, T.B. (Thomas B.), Kibsgård, T. (Thomas), Schaller, T.M. (Thomas M.), Ly, T.V. (Thuan V.), Miller, T.J. (Timothy J.), Weber, T. (Timothy), Le, T. (Toan), Oliver, T.M. (Todd M.), Karsten, T.M. (Thomas), Borch, T. (Tor), Hoseth, T.M. (Tor Magne), Nicolaisen, T. (Tor), Ianssen, T. (Torben), Rutherford, T. (Tori), Nanney, T. (Tracy), Gervais, T. (Trevor), Stone, T. (Trevor), Schrickel, T. (Tyson), Scrabeck, T. (Tyson), Ganguly, U. (Utsav), Naumetz, V. (V.), Frizzell, V. (Valda), Wadey, V. (Veronica), Jones, V. (Vicki), Avram, V. (Victoria), Mishra, V. (Vimlesh), Yadav, V. (Vineet), Arora, V. (Vinod), Tyagi, V. (Vivek), Borsella, V. (Vivian), Willems, W.J. (Jaap), Hoffman, W.H. (W. H.), Gofton, W.T. (Wade T.), Lackey, W.G. (Wesley G.), Ghent, W. (Wesley), Obremskey, W. (William), Oxner, W. (William), Cross, W.W. (William W.), Murtha, Y.M. (Yvonne M.), Murdoch, Z. (Zoe), Nauth, A. (Aaron), Creek, A.T. (Aaron T.), Zellar, A. (Abby), Lawendy, A.-R. (Abdel-Rahman), Dowrick, A. (Adam), Gupta, A. (Ajay), Dadi, A. (Akhil), Kampen, A. (A.) van, Yee, A. (Albert), Vries, A.C. (Alexander) de, de Mol van Otterloo, A. (Alexander), Garibaldi, A. (Alisha), Liew, A. (Allen), McIntyre, A.W. (Allison W.), Prasad, A.S. (Amal Shankar), Romero, A.W. (Amanda W.), Rangan, A. (Amar), Oatt, A. (Amber), Sanghavi, A. (Amir), Foley, A.L. (Amy L.), Karlsten, A. (Anders), Dolenc, A. (Andrea), Bucknill, A. (Andrew), Chia, A. (Andrew), Evans, A. (Andrew), Gong, A. (Andrew), Schmidt, A.H. (Andrew H.), Marcantonio, A.J. (Andrew J.), Jennings, A. (Andrew), Ward, A. (Angela), Khanna, A. (Angshuman), Rai, A. (Anil), Smits, A.B. (Anke B.), Horan, A.D. (Annamarie D.), Brekke, A.C. (Anne Christine), Flynn, A. (Annette), Duraikannan, A. (Aravin), Stødle, A. (Are), van Vugt, A.B. (Arie B.), Luther, A. (Arlene), Zurcher, A.W. (Arthur W.), Jain, A. (Arvind), Amundsen, A. (Asgeir), Moaveni, A. (Ash), Carr, A. (Ashley), Sharma, A. (Ateet), Hill, A.D. (Austin D.), Trommer, A. (Axel), Rai, B.S. (B. Sachidananda), Hileman, B. (Barbara), Schreurs, B. (Bart), Verhoeven, B. (Bart), Barden, B.B. (Benjamin B.), Flatøy, B. (Bernhard), Cleffken, B.I. (Berry), Bøe, B. (Berthe), Perey, B. (Bertrand), Hanusch, B.C. (Birgit C.), Weening, B. (Brad), Fioole, B. (Bram), Rijbroek, B. (Bram), Crist, B.D. (Brett D.), Halliday, B. (Brett), Peterson, B. (Brett), Mullis, B. (Brian), Richardson, C.G. (C. Glen), Clark, C. (Callum), Sagebien, C.A. (Carlos A.), Pol, C. (Carmen) van der, Bowler, C. (Carol), Humphrey, C.A. (Catherine A.), Coady, C. (Catherine), Koppert, C.L. (Cees L.), Coles, C. (Chad), Tannoury, C. (Chadi), DePaolo, C.J. (Charles J.), Gayton, C. (Chris), Herriott, C. (Chris), Reeves, C. (Christina), Tieszer, C. (Christina), Dobb, C. (Christine), Anderson, C.G. (Christopher G.), Sage, C. (Claire), Cuento, C. (Claudine), Jones, C.B. (Clifford B.), Bosman, C.H.R. (Coks H.R.), Linehan, C. (Colleen), Hart, C.P. (Cor P.) van der, Henderson, C. (Corey), Lewis, C.G. (Courtland G.), Davis, C.A. (Craig A.), Donohue, C. (Craig), Mauffrey, C. (Cyril), Sundaresh, D.C. (D. C.), Farrell, D.J. (Dana J.), Whelan, D.B. (Daniel B.), Horwitz, D. (Daniel), Stinner, D. (Daniel), Viskontas, D. (Darius), Roffey, D.M. (Darren M.), Alexander, D. (David), Karges, D.E. (David E.), Hak, D. (David), Johnston, D. (David), Love, D. (David), Wright, D.M. (David M.), Zamorano, D.P. (David P.), Goetz, D.R. (David R.), Sanders, D. (David), Stephen, D. (David), Yen, D. (David), Bardana, D. (Davide), Olakkengil, D.J. (Davy J), Lawson, D. (Deanna), Maddock, D. (Deborah), Sietsema, D.L. (Debra L.), Pourmand, D. (Deeba), Hartog, D. (Dennis) den, Donegan, D. (Derek), Heels-Ansdell, D. (Diane), Nam, D. (Diane), Inman, D. (Dominic), Boyer, D. (Dory), Li, D. (Doug), Gibula, D. (Douglas), Price, D.M. (Dustin M.), Watson, D.J. (Dylan J.), Hammerberg, E.M. (E. Mark), Tan, E.T.C.H. (Edward T.C.H.), Graaf, E.J.R. (Eelco) de, Vesterhus, E.B. (Elise Berg), Roper, E. (Elizabeth), Edwards, E. (Elton), Schemitsch, E.H. (Emil), Hammacher, E.R. (Eric), Henderson, E.R. (Eric R.), Whatley, E. (Erica), Torres, E.T. (Erick T.), Vermeulen, E.G.J. (Erik G.J.), Finn, E. (Erin), Lieshout, E.M.M. (Esther) van, Wai, E.K. (Eugene K.), Bannister, E.R. (Evan R.), Kile, E. (Evelyn), Theunissen, E.B.M. (Evert B.M.), Ritchie, E.D. (Ewan D.), Khan, F. (Farah), Moola, F. (Farhad), Howells, F. (Fiona), Nies, F. (Frank) de, Heijden, F.H.W.M. (Frank) van der, de Meulemeester, F.R.A.J. (Frank R.A.J.), Frihagen, F. (Frede), Nilsen, F. (Fredrik), Schmidt, G.B. (G. Ben), Albers, G.H.R. (G.H. Robert), Gudger, G.K. (Garland K.), Johnson, G. (Garth), Gruen, G. (Gary), Zohman, G. (Gary), Sharma, G. (Gaurav), Wood, G. (Gavin), Tetteroo, G.W.M. (Geert), Hjorthaug, G. (Geir), Jomaas, G. (Geir), Donald, G. (Geoff), Rieser, G.R. (Geoffrey Ryan), Reardon, G. (Gerald), Slobogean, G.P. (Gerard P.), Roukema, G.R. (Gert), Visser, G.A. (Gijs A.), Moatshe, G. (Gilbert), Horner, G. (Gillian), Rose, G. (Glynis), Guyatt, G. (Gordon), Chuter, G. (Graham), Etherington, G. (Greg), Rocca, G.J.D. (Gregory J. Della), Ekås, G. (Guri), Dobbin, G. (Gwendolyn), Lemke, H.M. (H. Michael), Curry, H. (Hamish), Boxma, H. (Han), Gissel, H. (Hannah), Kreder, H. (Hans), Kuiken, H. (Hans), Brom, H.L.F., Pape, H.-C. (Hans-Christoph), Vis, H.M. (Harm) van der, Bedi, H. (Harvinder), Vallier, H.A. (Heather A.), Brien, H. (Heather), Silva, H. (Heather), Newman, H. (Heike), Viveiros, H. (Helena), van der Hoeven, H. (Henk), Ahn, H. (Henry), Johal, H. (Herman), Rijna, H., Stockmann, H. (Heyn), Josaputra, H.A. (Hong A.), Carlisle, H. (Hope), van der Brand, I. (Igor), Dawson, I. (Imro), Tarkin, I. (Ivan), Wong, I. (Ivan), Parr, J.A. (J. Andrew), Trenholm, J.A. (J. Andrew), Goslings, J.C. (Carel), Amirault, J.D. (J. David), Broderick, J.S. (J. Scott), Snellen, J.P. (Jaap P.), Zijl, J.A.C. (Jacco A.C.), Ahn, J. (Jaimo), Ficke, J. (James), Irrgang, J. (James), Powell, J. (James), Ringler, J.R. (James R.), Shaer, J. (James), Monica, J.T. (James T.), Biert, J. (Jan), Bosma, J. (Jan), Brattgjerd, J.E. (Jan Egil), Frölke, J.P.M. (Jan Paul), Wille, J.C. (Jan), Rajakumar, J. (Janakiraman), Walker, J.E. (Jane E.), Baker, J.K. (Janell K.), Ertl, J.P. (Janos P.), de Vries, J.P.P.M. (Jean Paul P.M.), Gardeniers, J.W.M. (Jean W.M.), May, J. (Jedediah), Yach, J. (Jeff), Hidy, J.T. (Jennifer T.), Westberg, J.R. (Jerald R.), Hall, J.A. (Jeremy A.), van Mulken, J. (Jeroen), McBeth, J.C. (Jessica Cooper), Hoogendoorn, J. (Jochem), Hoffman, J.M. (Jodi M.), Cherian, J.J. (Joe Joseph), Tanksley, J.A. (John A.), Clarke-Jenssen, J. (John), Adams, J.D. (John D.), Esterhai, J. (John), Tilzey, J.F. (John F.), Murnaghan, J. (John), Ketz, J.P. (John P.), Garfi, J.S. (John S.), Schwappach, J. (John), Gorczyca, J.T. (John T.), Wyrick, J. (John), Rydinge, J. (Jonas), Foret, J.L. (Jonathan L.), Gross, J.M. (Jonathan M.), Keeve, J.P. (Jonathan P.), Meijer, J. (Joost), Scheepers, J.J. (Joris J.), Baele, J. (Joseph), O'Neil, J. (Joseph), Cass, J.R. (Joseph R.), Hsu, J.R. (Joseph R.), Dumais, J. (Jules), Lee, J. (Julia), Switzer, J.A. (Julie A.), Agel, J. (Julie), Richards, J.E. (Justin E.), Langan, J.W. (Justin W.), Turckan, K. (Kahn), Pecorella, K. (Kaili), Rai, K. (Kamal), Aurang, K. (Kamran), Shively, K. (Karl), Wessem, K.J.P. van, Moon, K. (Karyn), Eke, K. (Kate), Erwin, K. (Katie), Milner, K. (Katrine), Ponsen, K.J. (Kees-jan), Mills, K. (Kelli), Apostle, K. (Kelly), Johnston, K. (Kelly), Trask, K. (Kelly), Strohecker, K. (Kent), Stringfellow, K. (Kenya), Kruse, K.K. (Kevin K.), Tetsworth, K. (Kevin), Mitchell, K. (Khalis), Browner, K. (Kieran), Hemlock, K. (Kim), Carcary, K. (Kimberly), Jørgen Haug, K. (Knut), Noble, K. (Krista), Robbins, K. (Kristin), Payton, K. (Krystal), Jeray, K.J. (Kyle J.), Rubino, L.J. (L. Joseph), Nastoff, L.A. (Lauren A.), Leffler, L.C. (Lauren C.), Stassen, L.P. (Laurents), O'Malley, L.K. (Lawrence K.), Specht, L.M. (Lawrence M.), Thabane, L. (Lehana), Geeraedts, L.M.G. (Leo M.G.), Shell, L.E. (Leslie E.), Anderson, L.K. (Linda K.), Eickhoff, L.S. (Linda S.), Lyle, L. (Lindsey), Pilling, L. (Lindsey), Buckingham, L. (Lisa), Cannada, L.K. (Lisa K.), Wild, L.M. (Lisa M.), Dulaney-Cripe, L. (Liz), Poelhekke, L.M.S.J., Govaert, L. (Lonneke), Ton, L. (Lu), Kottam, L. (Lucksy), Leenen, L.P.H. (Luke), Clipper, L. (Lydia), Jackson, L.T. (Lyle T.), Hampton, L. (Lynne), de Waal Malefijt, M.C. (Maarten C.), Simons, M.P., Elst, M. (Maarten) van der, Bronkhorst, M.W.G.A. (Maarten), Bhatia, M. (Mahesh), Swiontkowski, M.F. (Marc ), Lobo, M.J. (Margaret J.), Swinton, M. (Marilyn), Pirpiris, M. (Marinis), Molund, M. (Marius), Gichuru, M. (Mark), Glazebrook, M. (Mark), Harrison, M. (Mark), Jenkins, M. (Mark), MacLeod, M. (Mark), Vries, M.R. (Mark) de, Butler, M.S. (Mark S.), Nousiainen, M. (Markku), van ‘t Riet, M. (Martijne), Tynan, M.C. (Martin C.), Campo, M. (Martin), Eversdijk, M.G. (Martin), Heetveld, M.J. (Martin), Richardson, M. (Martin), Breslin, M. (Mary), Fan, M. (Mary), Edison, M. (Matt), Napierala, M. (Matthew), Knobe, M. (Matthias), Russ, M. (Matthias), Zomar, M. (Mauri), de Brauw, M. (Maurits), Esser, M. (Max), Hurley, M. (Meghan), Peters, M.E. (Melissa E.), Lorenzo, M. (Melissa), Li, M. (Mengnai), Archdeacon, M. (Michael), Biddulph, M. (Michael), Charlton, M. (Michael), McDonald, M.D. (Michael D.), McKee, M.D. (Michael D.), Dunbar, M. (Michael), Torchia, M.E. (Michael E.), Gross, M. (Michael), Hewitt, M. (Michael), Holt, M. (Michael), Prayson, M.J. (Michael J.), Edwards, M.J.R. (Michael), Beckish, M.L. (Michael L.), Brennan, M.L. (Michael L.), Dohm, M.P. (Michael P.), Kain, M.S.H. (Michael S.H.), Vogt, M. (Michelle), Yu, M. (Michelle), Verhofstad, M.H.J. (Michiel), Segers, M.J.M. (Michiel J.M.), Segers, M.J.M. (Michiel), Siroen, M.P.C. (Michiel P.C.), Reed, M.R. (Mike), Vicente, M.R. (Milena R.), Bruijninckx, M.M.M. (Milko), Trivedi, M. (Mittal), Bhandari, M. (Mohit), Moore, M.M. (Molly M.), Kunz, M. (Monica), Smedsrud, M. (Morten), Palla, N. (Naveen), Jain, N. (Neeraj), Out, N.J.M. (Nico J.M.), Simunovic, N. (Nicole), Schep, N.W.L. (Niels), Müller, O. (Oliver), Guicherit, O.R. (Onno R.), Waes, O.J.F. (Oscar) van, Wang, O. (Otis), Doornebosch, P. (Pascal), Seuffert, P. (Patricia), Hesketh, P.J. (Patrick J.), Weinrauch, P. (Patrick), Duffy, P. (Paul), Keller, P. (Paul), Lafferty, P.M. (Paul M.), Pincus, P. (Paul), Tornetta III, P. (Paul), Zalzal, P. (Paul), McKay, P. (Paula), Cole, P.A. (Peter A.), de Rooij, P.D. (Peter D.), Hull, P. (Peter), Go, P.M.N.Y.M. (Peter M.N.Y.M.), Patka, P. (Peter), Siska, P. (Peter), Weingarten, P. (Peter), Kregor, P. (Philip), Stahel, P. (Philip), Stull, P. (Philip), Wittich, P. (Philippe), Rijcke, P.A.R. (Piet), Oprel, P.P. (Pim), Devereaux, P.J. (P. J.), Zhou, Q. (Qi), Lee Murphy, R. (R.), Alosky, R. (Rachel), Clarkson, R. (Rachel), Moon, R. (Raely), Logishetty, R. (Rajanikanth), Nanda, R. (Rajesh), Sullivan, R.J. (Raymond J.), Snider, R.G. (Rebecca G.), Buckley, R.E. (Richard E.), Iorio, R. (Richard), Farrugia, R.J. (Richard J), Jenkinson, R. (Richard), Laughlin, R. (Richard), Groenendijk, R.P.R. (Richard), Gurich, R.W. (Richard W.), Worman, R. (Ripley), Silvis, R. (Rob), Haverlag, R. (Robert), Teasdall, R.J. (Robert J.), Korley, R. (Robert), McCormack, R. (Robert), Probe, R. (Robert), Cantu, R.V. (Robert V.), Huff, R.B. (Roger B.), Simmermacher, R.K.J., Peters, R. (Rolf), Pfeifer, R. (Roman), Liem, R. (Ronald), Wessel, R.N. (Ronald N.), Verhagen, R. (Ronald), Vuylsteke, R. (Ronald), Leighton, R. (Ross), McKercher, R. (Ross), Poolman, R.W. (Rudolf), Miller, R. (Russell), Bicknell, R. (Ryan), Finnan, R. (Ryan), Khan, R.M. (Ryan M.), Mehta, S. (Samir), Vang, S. (Sandy), Singh, S. (Sanjay), Anand, S. (Sanjeev), Anderson, S.A. (Sarah A.), Dawson, S.A. (Sarah A.), Marston, S.B. (Scott B.), Porter, S.E. (Scott E.), Watson, S.T. (Scott T.), Festen, S. (Sebastiaan), Lieberman, S. (Shane), Puloski, S. (Shannon), Bielby, S.A. (Shea A.), Sprague, S. (Sheila), Hess, S. (Shelley), MacDonald, S. (Shelley), Evans, S. (Simone), Bzovsky, S. (Sofia), Hasselund, S. (Sondre), Lewis, S. (Sophie), Ugland, S. (Stein), Caminiti, S. (Stephanie), Tanner, S.L. (Stephanie L.), Zielinski, S.M. (Stephanie), Shepard, S. (Stephanie), Sems, S.A. (Stephen A.), Walter, S.D. (Stephen D.), Doig, S. (Stephen), Finley, S.H. (Stephen H.), Kates, S. (Stephen), Lindenbaum, S. (Stephen), Kingwell, S.P. (Stephen P.), Csongvay, S. (Steve), Papp, S. (Steve), Buijk, S.E. (Steven E.), Rhemrev, S. (Steven), Hollenbeck, S.M. (Steven M.), van Gaalen, S.M. (Steven M.), Yang, S. (Steven), Weinerman, S. (Stuart), Subash, (), Lambert, S. (Sue), Liew, S. (Susan), Meylaerts, S.A.G. (Sven), Blokhuis, T.J. (Taco J.), de Vries Reilingh, T.S. (Tammo S.), Lona, T. (Tarjei), Scott, T. (Taryn), Swenson, T.K. (Teresa K.), Endres, T.J. (Terrence J.), Axelrod, T. (Terry), van Egmond, T. (Teun), Pace, T.B. (Thomas B.), Kibsgård, T. (Thomas), Schaller, T.M. (Thomas M.), Ly, T.V. (Thuan V.), Miller, T.J. (Timothy J.), Weber, T. (Timothy), Le, T. (Toan), Oliver, T.M. (Todd M.), Karsten, T.M. (Thomas), Borch, T. (Tor), Hoseth, T.M. (Tor Magne), Nicolaisen, T. (Tor), Ianssen, T. (Torben), Rutherford, T. (Tori), Nanney, T. (Tracy), Gervais, T. (Trevor), Stone, T. (Trevor), Schrickel, T. (Tyson), Scrabeck, T. (Tyson), Ganguly, U. (Utsav), Naumetz, V. (V.), Frizzell, V. (Valda), Wadey, V. (Veronica), Jones, V. (Vicki), Avram, V. (Victoria), Mishra, V. (Vimlesh), Yadav, V. (Vineet), Arora, V. (Vinod), Tyagi, V. (Vivek), Borsella, V. (Vivian), Willems, W.J. (Jaap), Hoffman, W.H. (W. H.), Gofton, W.T. (Wade T.), Lackey, W.G. (Wesley G.), Ghent, W. (Wesley), Obremskey, W. (William), Oxner, W. (William), Cross, W.W. (William W.), Murtha, Y.M. (Yvonne M.), and Murdoch, Z. (Zoe)

Abstract

Background Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled trial, we enrolled patients aged 50 years or older with a low-energy hip fracture requiring fracture fixation from 81 clinical centres in eight countries. Patients were assigned by minimisation with a centralised computer system to receive a single large-diameter screw with a side-plate (sliding hip screw) or the present standard of care, multiple small-diameter cancellous screws. Surgeons and patients were not blinded but the data analyst, while doing the analyses, remained blinded to treatment groups. The primary outcome was hip reoperation within 24 months after initial surgery to promote fracture healing, relieve pain, treat infection, or improve function. Analyses followed the intention-to-treat principle. This study was registered with ClinicalTrials.gov, number NCT00761813. Findings Between Marc

Published
2017
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13. Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial.

Author

Nauth, A., Creek, A.T., Zellar, A., Lawendy, A.R., Dowrick, A., Gupta, A., Dadi, A., Kampen, A. van, Yee, A., Vries, A.C. de, Mol van Otterloo, A., Garibaldi, A., Liew, A., McIntyre, A.W., Prasad, A.S., Romero, A.W., Rangan, A., Oatt, A., Sanghavi, A., Foley, A.L., Karlsten, A., Dolenc, A., Bucknill, A., Chia, A., Gong, A., Schmidt, A.H., Marcantonio, A.J., Jennings, A., Khanna, A., Rai, A., Horan, A.D., Brekke, A.C., Flynn, A., Duraikannan, A., Stodle, A., Vugt, A.B. van, Luther, A., Zurcher, A.W., Jain, A., Amundsen, A., Moaveni, A., Carr, A., Sharma, A., Hill, A.D., Trommer, A., Rai, B.S., Hileman, B., Schreurs, B.W., Verhoeven, B., Barden, B.B., Flatoy, B., Cleffken, B.I., Boe, B., Perey, B., Hanusch, B.C., Weening, B., Fioole, B., Rijbroek, B., Crist, B.D., Halliday, B., Peterson, B., Mullis, B., Richardson, C.G., Clark, C., Sagebien, C.A., Pol, C.C. van der, Bowler, C., Humphrey, C.A., Coady, C., Koppert, C.L., Tannoury, C., Paolo, C.J. de, Gayton, C., Herriott, C., Reeves, C., Tieszer, C., Dobb, C., Anderson, C.G., Sage, C, Cuento, C., Jones, C.B., Bosman, C.H.R., Linehan, C., Hart, C.P. van der, Henderson, C., Lewis, C.G., Davis, C.A., Donohue, C., Mauffrey, C., Sundaresh, D.C., Farrell, D.J., Whelan, D.B., Horwitz, D., Stinner, D., Viskontas, D., Roffey, D.M., Alexander, D., Karges, D.E., Love, D., Wright, D.M., Zamorano, D.P., Goetz, D.R., Sanders, D., Yen, D., Bardana, D., Olakkengil, D.J., Lawson, D., Maddock, D., Sietsema, D.L., Pourmand, D., Hartog, D. Den, Donegan, D., Heels-Ansdell, D., Nam, D., Inman, D., Boyer, D., Li, D., Gibula, D., Price, D.M., Hammerberg, E.M., Tan, E.C.T.H., Graaf, E.J. de, Vesterhus, E.B., Roper, E., Edwards, E., Schemitsch, E.H., Hammacher, E.R., Henderson, E.R., Whatley, E., Torres, E.T., Vermeulen, E.G.J., Finn, E., Lieshout, E.M. van, Wai, E.K., Bannister, E.R., Kile, E., Theunissen, E.B.M., Ritchie, E.D., Moola, F., Howells, F., Nies, F. de, Heijden, F.H. van der, Meulemeester, F.R. de, Frihagen, F., Nilsen, F., Schmidt, G.B., Albers, G.H.R., Gudger, G.K., Johnson, G., Gruen, G., Zohman, G., Wood, G, Tetteroo, G.W., Hjorthaug, G., Jomaas, G., Donald, G., Rieser, G.R., Reardon, G., Slobogean, G.P., Roukema, G.R., Visser, G., Moatshe, G., Horner, G., Gardeniers, J.W.M., Waal Malefijt, M.C. de, et al., Nauth, A., Creek, A.T., Zellar, A., Lawendy, A.R., Dowrick, A., Gupta, A., Dadi, A., Kampen, A. van, Yee, A., Vries, A.C. de, Mol van Otterloo, A., Garibaldi, A., Liew, A., McIntyre, A.W., Prasad, A.S., Romero, A.W., Rangan, A., Oatt, A., Sanghavi, A., Foley, A.L., Karlsten, A., Dolenc, A., Bucknill, A., Chia, A., Gong, A., Schmidt, A.H., Marcantonio, A.J., Jennings, A., Khanna, A., Rai, A., Horan, A.D., Brekke, A.C., Flynn, A., Duraikannan, A., Stodle, A., Vugt, A.B. van, Luther, A., Zurcher, A.W., Jain, A., Amundsen, A., Moaveni, A., Carr, A., Sharma, A., Hill, A.D., Trommer, A., Rai, B.S., Hileman, B., Schreurs, B.W., Verhoeven, B., Barden, B.B., Flatoy, B., Cleffken, B.I., Boe, B., Perey, B., Hanusch, B.C., Weening, B., Fioole, B., Rijbroek, B., Crist, B.D., Halliday, B., Peterson, B., Mullis, B., Richardson, C.G., Clark, C., Sagebien, C.A., Pol, C.C. van der, Bowler, C., Humphrey, C.A., Coady, C., Koppert, C.L., Tannoury, C., Paolo, C.J. de, Gayton, C., Herriott, C., Reeves, C., Tieszer, C., Dobb, C., Anderson, C.G., Sage, C, Cuento, C., Jones, C.B., Bosman, C.H.R., Linehan, C., Hart, C.P. van der, Henderson, C., Lewis, C.G., Davis, C.A., Donohue, C., Mauffrey, C., Sundaresh, D.C., Farrell, D.J., Whelan, D.B., Horwitz, D., Stinner, D., Viskontas, D., Roffey, D.M., Alexander, D., Karges, D.E., Love, D., Wright, D.M., Zamorano, D.P., Goetz, D.R., Sanders, D., Yen, D., Bardana, D., Olakkengil, D.J., Lawson, D., Maddock, D., Sietsema, D.L., Pourmand, D., Hartog, D. Den, Donegan, D., Heels-Ansdell, D., Nam, D., Inman, D., Boyer, D., Li, D., Gibula, D., Price, D.M., Hammerberg, E.M., Tan, E.C.T.H., Graaf, E.J. de, Vesterhus, E.B., Roper, E., Edwards, E., Schemitsch, E.H., Hammacher, E.R., Henderson, E.R., Whatley, E., Torres, E.T., Vermeulen, E.G.J., Finn, E., Lieshout, E.M. van, Wai, E.K., Bannister, E.R., Kile, E., Theunissen, E.B.M., Ritchie, E.D., Moola, F., Howells, F., Nies, F. de, Heijden, F.H. van der, Meulemeester, F.R. de, Frihagen, F., Nilsen, F., Schmidt, G.B., Albers, G.H.R., Gudger, G.K., Johnson, G., Gruen, G., Zohman, G., Wood, G, Tetteroo, G.W., Hjorthaug, G., Jomaas, G., Donald, G., Rieser, G.R., Reardon, G., Slobogean, G.P., Roukema, G.R., Visser, G., Moatshe, G., Horner, G., Gardeniers, J.W.M., Waal Malefijt, M.C. de, and et al.

Abstract

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Published
2017

14. Long-term outcomes in patients with multiple endocrine neoplasia type 1 and pancreaticoduodenal neuroendocrine tumours

Author

Donegan, D., Singh Ospina, Naykky, Rodríguez Gutiérrez, René, Al Hilli, Zahraa, Thompson, G. B., Clarke, B. L., Young, W. F., Donegan, D., Singh Ospina, Naykky, Rodríguez Gutiérrez, René, Al Hilli, Zahraa, Thompson, G. B., Clarke, B. L., and Young, W. F.

Abstract

Summary Background In patients with multiple endocrine neoplasia type 1 (MEN-1), pancreaticoduodenal (PD) neuroendocrine tumours (NETs) are associated with early mortality, yet the best treatment strategy remains uncertain. Aim To assess patient important outcomes (mortality and metastasis) of PD-NETs and predictors of outcomes in patients with MEN-1. Methods Retrospective cohort of patients with MEN-1 who attended the Mayo Clinic, Rochester, MN from 1997 to 2014. Results We identified 287 patients with MEN-1; 199 (69%) patients had 217 PD-NETs. Among those with a PD-NETs, 129 (65%) had surgery of which 90 (70%) had their primary surgery performed at Mayo Clinic. The median postoperative follow-up was 8 years during which 13 (14%) patients died. The mean (±standard deviation) age of death was 51 (±9) years. Tumour size, metastasis at surgery or tumour type were not predictive of mortality, but for every year older at surgery, the odds of metastasis increased by 6%. Surgery was not performed in 70 (35%) patients. Among those who were observed/medically managed without known metastatic disease, mean tumour growth was 0·02 cm/year (range, -0·13–0-4 cm/year). Four patients (7%) died at a median age of 77 (range, 51–89) years. Conclusion PD-NETs are common in patients with MEN-1 and are associated with early mortality even after surgical intervention. Active surveillance is a viable option in nonaggressive PD-NETs, although definitive factors identifying such patients are lacking. Therefore, counselling regarding risks and benefits of current treatment options remains integral to the care of patients with MEN-1.

Published
2016

16. Long-term metabolic risk for the metabolically healthy overweight/obese phenotype

Author

Espinosa De Ycaza, AE, Donegan, D, and Jensen, M D

Abstract

Background/Objectives:The clinical relevance of the metabolically healthy overweight/obese (MHO) phenotype is controversial and the relationships between weight change and the development of cardiometabolic risk factors is unknown. Therefore, we aim to: (1) Assess the long-term risk of developing one or more components of the metabolic syndrome in MHO adults compared with metabolically healthy normal weight (MHNW); (2) Evaluate risk of a composite of death, cardiovascular disease (CVD), and risk of developing type 2 diabetes between adults defined according to baseline body mass index and metabolic health.Subjects/Methods:Retrospective cohort study of adults 18–65 years of age seen at our institution between 1998 and 2000 who lived in Olmsted County. Metabolically healthy was defined as the absence of all components of the metabolic syndrome (except for waist circumference). Main outcome was the development of metabolic risk factors. The secondary outcome was a composite of mortality, CVD and heart failure.Results:Of the 18?070 individuals with complete data at baseline, 1805 (10%) were MHO (mean age 38±11 years) and 3047 were MHNW (mean age 35±11 years). After a median follow-up of 15 years, interquartile range 10–17, 80% of MHO vs 68% of MHNW developed at least one cardiometabolic risk factor (P<0.001). In multivariate analysis, MHO individuals who gained ?10% of their body weight were more likely to have developed metabolic complications compared to MHO individuals that did not gain weight (P=0.001 for 10–15%, P<0.001 for >15% weight gain). The risk for the secondary composite end point was similar between MHO and MHNW, number of events 218/1805 vs 217/3048 for MHO and MHNW, respectively, (hazard ratio: 1.16, 95% confidence interval: 0.96–1.40).Conclusions:MHO are more likely to develop metabolic complications than MHNW, especially if they gain weight.

Published
2018
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19. Intra-operative quality assessment of coronary artery bypass grafts.

Author

Groom, R., Tryzelaar, J., Forest, R., Niimi, K., Cecere, G., Donegan, D., Katz, S., Weldner, P., Quinn, R., Braxton, J., Blank, S., Kramer, R., and Morton, J.

Subjects
CORONARY artery bypass, GRAFT rejection
Abstract

Early coronary artery bypass graft (CABG) failure is a troubling complication that may result in a wide range of problems, including refractory angina, myocardial infarction, low cardiac output, arrhythmia, and fatal heart failure. Early graft failures are related to poor quality and size of the distal native vascular bed, coagulation abnormalities, or technical problems involving the graft conduits and anastomoses. Unfortunately, graft failure is difficult to detect during surgery by visual assessment, palpation, or conventional monitoring. We evaluated the accuracy and utility of a transit-time, ultrasonic flow measurement system for measurement of CABGs. There were no differences between transit-time measurements and volumetric-time collected samples in an in vitro circuit over a range of flows from 10 to 100 ml/min (Bland and Altman Plot, 1.96 SD). Two hundred and ninety-eight CABGs were examined in 125 patients. Graft flow rate was proportional to the target vessel diameter. Nine technical errors were detected and corrected. Flow waveform morphology provided valuable information related to the quality of the anastamosis, which led to the immediate correction of technical problems at the time of surgery. [ABSTRACT FROM AUTHOR]

Published
2001
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32. Autologous stem cell transplantation in adults with atypical teratoid rhabdoid tumor: a case report and review.

Author

Griffith-Linsley J, Bell WR, Cohen-Gadol A, Donegan D, Richardson A, Robertson M, Shiue K, and Nevel K

Subjects
Humans, Adult, Stem Cell Transplantation methods, Male, Female, Brain Neoplasms therapy, Brain Neoplasms pathology, Brain Neoplasms surgery, Rhabdoid Tumor therapy, Rhabdoid Tumor pathology, Rhabdoid Tumor surgery, Transplantation, Autologous, Teratoma therapy, Teratoma pathology, Teratoma surgery
Abstract

Aim: Atypical teratoid rhabdoid tumor (ATRT) is a rare and highly aggressive primary CNS neoplasm, predominantly observed in children. The use of autologous stem cell transplantation (ASCT) in pediatric ATRT has shown promise; however, its utility in adult ATRT remains unclear. Patients & methods: This study presents the case of an adult patient with ATRT who is in remission after ASCT and reviews the literature on ASCT in adults with ATRT. Four cases of ATRT in adults who underwent ASCT were identified, with pertinent data summarized. Results: All five patients survived longer than the historical average survival rate, four of whom had no clinical or radiographic evidence of disease at the final follow-up. Conclusion: Based on limited data, there may be a role for ASCT in the treatment of adults with ATRT.

Published
2024
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33. Orexin neurons track temporal features of blood glucose in behaving mice.

Author

Viskaitis P, Tesmer AL, Liu Z, Karnani MM, Arnold M, Donegan D, Bracey E, Grujic N, Patriarchi T, Peleg-Raibstein D, and Burdakov D

Subjects
Animals, Male, Mice, Mice, Inbred C57BL, Locomotion physiology, Arousal physiology, Behavior, Animal physiology, Orexins metabolism, Blood Glucose metabolism, Neurons physiology, Neurons metabolism
Abstract

Does the brain track how fast our blood glucose is changing? Knowing such a rate of change would enable the prediction of an upcoming state and a timelier response to this new state. Hypothalamic arousal-orchestrating hypocretin/orexin neurons (HONs) have been proposed to be glucose sensors, yet whether they track glucose concentration (proportional tracking) or rate of change (derivative tracking) is unknown. Using simultaneous recordings of HONs and blood glucose in behaving male mice, we found that maximal HON responses occur in considerable temporal anticipation (minutes) of glucose peaks due to derivative tracking. Analysis of >900 individual HONs revealed glucose tracking in most HONs (98%), with derivative and proportional trackers working in parallel, and many (65%) HONs multiplexed glucose and locomotion information. Finally, we found that HON activity is important for glucose-evoked locomotor suppression. These findings reveal a temporal dimension of brain glucose sensing and link neurobiological and algorithmic views of blood glucose perception in the brain's arousal orchestrators., (© 2024. The Author(s).)

Published
2024
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34. High-mobility group box 1 increases platelet surface P2Y12 and platelet activation in sickle cell disease.

Author

Nolfi-Donegan D, Annarapu GK, St Croix C, Calderon M, Hillery CA, and Shiva S

Subjects
Humans, Blood Platelets metabolism, Inflammation metabolism, Platelet Activation, Anemia, Sickle Cell, HMGB1 Protein metabolism, Thrombosis metabolism
Abstract

Thrombosis and inflammation are intimately linked and synergistically contribute to the pathogenesis of numerous thromboinflammatory diseases, including sickle cell disease (SCD). While platelets are central to thrombogenesis and inflammation, the molecular mechanisms of crosstalk between the 2 remain elusive. High-mobility group box 1 (HMGB1) regulates inflammation and stimulates platelet activation through Toll-like receptor 4. However, it remains unclear whether HMGB1 modulates other thrombotic agonists to regulate platelet activation. Herein, using human platelets, we demonstrate that HMGB1 significantly enhanced ADP-mediated platelet activation. Furthermore, inhibition of the purinergic receptor P2Y12 attenuated HMGB1-dependent platelet activation. Mechanistically, we show that HMGB1 stimulated ADP secretion, while concomitantly increasing P2Y12 levels at the platelet membrane. We show that in SCD patients, increased plasma HMGB1 levels were associated with heightened platelet activation and surface P2Y12 expression. Treatment of healthy platelets with plasma from SCD patients enhanced platelet activation and surface P2Y12, and increased sensitivity to ADP-mediated activation, and these effects were linked to plasma HMGB1. We conclude that HMGB1-mediated platelet activation involves ADP-dependent P2Y12 signaling, and HMGB1 primes platelets for ADP signaling. This complementary agonism between ADP and HMGB1 furthers the understanding of thromboinflammatory signaling in conditions such as SCD, and provides insight for therapeutic P2Y12 inhibition.

Published
2024
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35. Long-term Outcomes with Spinal versus General Anesthesia for Hip Fracture Surgery: A Randomized Trial.

Author

Vail EA, Feng R, Sieber F, Carson JL, Ellenberg SS, Magaziner J, Dillane D, Marcantonio ER, Sessler DI, Ayad S, Stone T, Papp S, Donegan D, Mehta S, Schwenk ES, Marshall M, Jaffe JD, Luke C, Sharma B, Azim S, Hymes R, Chin KJ, Sheppard R, Perlman B, Sappenfield J, Hauck E, Tierney A, Horan AD, and Neuman MD

Subjects
Humans, Anesthesia, General, Canada epidemiology, Treatment Outcome, Male, Female, Middle Aged, Aged, Anesthesia, Spinal, Hip Fractures surgery
Abstract

Background: The effects of spinal versus general anesthesia on long-term outcomes have not been well studied. This study tested the hypothesis that spinal anesthesia is associated with better long-term survival and functional recovery than general anesthesia., Methods: A prespecified analysis was conducted of long-term outcomes of a completed randomized superiority trial that compared spinal anesthesia versus general anesthesia for hip fracture repair. Participants included previously ambulatory patients 50 yr of age or older at 46 U.S. and Canadian hospitals. Patients were randomized 1:1 to spinal or general anesthesia, stratified by sex, fracture type, and study site. Outcome assessors and investigators involved in the data analysis were masked to the treatment arm. Outcomes included survival at up to 365 days after randomization (primary); recovery of ambulation among 365-day survivors; and composite endpoints for death or new inability to ambulate and death or new nursing home residence at 365 days. Patients were included in the analysis as randomized., Results: A total of 1,600 patients were enrolled between February 12, 2016, and February 18, 2021; 795 were assigned to spinal anesthesia, and 805 were assigned to general anesthesia. Among 1,599 patients who underwent surgery, vital status information at or beyond the final study interview (conducted at approximately 365 days after randomization) was available for 1,427 (89.2%). Survival did not differ by treatment arm; at 365 days after randomization, there were 98 deaths in patients assigned to spinal anesthesia versus 92 deaths in patients assigned to general anesthesia (hazard ratio, 1.08; 95% CI, 0.81 to 1.44, P = 0.59). Recovery of ambulation among patients who survived a year did not differ by type of anesthesia (adjusted odds ratio for spinal vs. general, 0.87; 95% CI, 0.67 to 1.14; P = 0.31). Other outcomes did not differ by treatment arm., Conclusions: Long-term outcomes were similar with spinal versus general anesthesia., (Copyright © 2023 American Society of Anesthesiologists. All Rights Reserved.)

Published
2024
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36. A Novel Preoperative Score to Predict Long-Term Biochemical Remission in Patients with Growth-Hormone Secreting Pituitary Adenomas.

Author

Cohen-Cohen S, Rindler R, Botello Hernandez E, Donegan D, Erickson D, Meyer FB, Atkinson JL, and Van Gompel JJ

Subjects
Humans, Retrospective Studies, Treatment Outcome, Remission Induction, Insulin, Growth Hormone-Secreting Pituitary Adenoma surgery, Growth Hormone-Secreting Pituitary Adenoma pathology, Pituitary Neoplasms surgery, Pituitary Neoplasms pathology, Adenoma surgery, Adenoma pathology, Acromegaly etiology, Acromegaly surgery
Abstract

Objective: Transsphenoidal surgery (TSS) is considered the treatment of choice in most patients with growth hormone (GH)-secreting pituitary adenomas. Several preoperative factors have been studied to predict postsurgical remission. Our objective was to design a score that could be used in the preoperative setting to identify patients that will achieve long-term biochemical remission after TSS., Methods: A retrospective analysis of consecutive patients with GH-secreting pituitary adenomas that underwent TSS in our institution from 2000 to 2015 who fulfilled prespecified criteria were included. Logistic regression methods were used to evaluate independent preoperative variables predicting long-term remission. Beta coefficients were used to create a scoring system for clinical practice., Results: Sixty-eight patients were included, with a mean follow-up time of 87 months. Twenty (29%) patients had tumors with a Knosp grade ≥ 3A. Gross-total resection was achieved in 43 (63%) patients. Thirty-three (48%) patients had long-term biochemical remission after TSS. In a multivariate analysis, the following variables were statistically significantly associated with long-term biochemical remission: age, adenoma size (diameter), Knosp grade, GH level, and insulin growth-factor 1index 1 at diagnosis. A score of <3 out of 8 total points was identified as a cutoff associated with long-term remission, with a sensitivity of 91.4% and specificity of 72.7% (AUC 0.867, OR 28.44, 95% CI 6.94-116.47, P = < 0.001)., Conclusions: A novel, simple, easy-to-use scoring system was created to identify patients with the highest chances of long-term biochemical remission following TSS. This scale should be prospectively validated in a multicenter study before widespread adoption., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Published
2024
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37. Postsurgical utility of copeptin for the prediction of postoperative arginine vasopressin deficiency.

Author

Donegan D, Bornhorst J, Van Gompel J, Atkinson J, Theobald JP, Meyer FF, Link MJ, Peris-Celda M, Spears G, and Erickson D

Subjects
Humans, Female, Male, Middle Aged, Adult, Aged, Predictive Value of Tests, Biomarkers blood, Pituitary Diseases surgery, Pituitary Diseases blood, Pituitary Diseases diagnosis, Glycopeptides blood, Arginine Vasopressin blood, Postoperative Complications blood, Postoperative Complications etiology, Postoperative Complications diagnosis, Neurosurgical Procedures adverse effects
Abstract

Objective: Arginine vasopressin deficiency (AVD) following neurosurgical procedures for pituitary disorders is common and can delay discharge. Copeptin, a stable surrogate marker of arginine vasopressin, may predict postoperative AVD. The authors' aim was to assess the optimal postoperative sampling time and cut-point concentration of copeptin to predict the development of postsurgical AVD., Methods: Adults without preexisting AVD who were undergoing surgery for a pituitary lesion between February 2020 and April 2022 were eligible for study inclusion. Two samples were drawn from each patient postoperatively to assess the copeptin concentration using an immunofluorescent assay. Samples were denoted as "early" (within 6 hours of extubation) or "postoperative day 1" (POD1; within 10-30 hours of extubation). Patients were evaluated for the development of AVD., Results: One hundred ninety-two patients (54.2% female) with a median age of 54.5 years (IQR 39.8-67.0 years) were included in the study. The median copeptin concentration at both time points was significantly lower in those with AVD (transient or permanent; n = 22, 11.5%) than in those without (early: 4.9 vs 18.7 pmol/L, p < 0.001; POD1: 3.4 vs 4.9 pmol/L, p < 0.001) but did not differ in those who developed transient versus permanent AVD. The optimal copeptin cut point for the prediction of AVD was < 8.5 pmol/L for early samples (sensitivity 0.70, specificity 0.80, positive predictive value [PPV] 0.29, negative predictive value [NPV] 0.96) and < 4.3 pmol/L for POD1 samples (sensitivity 0.82, specificity 0.63, PPV 0.22, NPV 0.96). In early samples, a copeptin cutoff of 22.9 pmol/L increased the sensitivity for the detection of AVD to 95% with an NPV of 99%. The proportion of patients who had AVD was higher (60.0% vs 8.8%, p < 0.001) and the copeptin concentration lower (early: 4.3 vs 17.0 pmol/L, p < 0.001; POD1: 2.7 vs 4.9 pmol/L, p < 0.001) among those who had undergone surgery for a craniopharyngeal duct pathology versus a pituitary adenoma. Although copeptin was lower in patients with persistent Cushing's disease than in those in remission, the difference did not reach statistical significance (early p = 0.11, POD1 p = 0.52). Furthermore, the copeptin concentration could not predict the development of syndrome of inappropriate secretion of antidiuretic hormone. Patients without AVD who had received stress dose steroids intraoperatively had lower median early copeptin (11.7 vs 19.1 pmol/L, p = 0.027)., Conclusions: In early postoperative copeptin samples, the optimal copeptin cut point for AVD diagnosis was < 8.5 pmol/L, and a level > 22.9 pmol/L had predicative utility in excluding AVD. Caution should be used when interpreting copeptin results, as patients administered glucocorticoids intraoperatively without AVD had lower median copeptin concentrations.

Published
2023
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38. High Dose of Metformin Decreases Susceptibility to Occlusive Arterial Thrombosis in Diabetic Mice.

Author

Mota Alvidrez RI, Annarapu GK, Srinivasan AJ, Liu Z, Yazdani HO, Simmons RL, Shiva S, Neal MD, and Nolfi-Donegan D

Abstract

Introduction: Metformin is the most prescribed medication in Diabetes Mellitus(DM). Metformin has shown to decrease mean platelet volume, with promising antiplatelet effects. High doses of Metformin have also been associated with hypercoagulation. We hypothesize that Metformin will protect DM mice from occlusive arterial thrombus formation by altering platelet activation and mitochondrial bioenergetics., Methods: DM was developed by low dose of Streptozotocin, healthy (non-DM) mice are controls. Either vehicle or Metformin was administered twice daily via oral gavage for 7-days. Ferric chloride (FeCl3) arterial thrombosis and tail bleeding time were performed. Whole blood aggregometry, platelet activation/adhesion and mitochondrial bioenergetics were evaluated., Results: Metformin decreased susceptibility of DM mice to arterial thrombosis. Platelet bioenergetics show DM mice have increased platelet mitochondrial respiration, but no differences were observed with Metformin treatment. In healthy mice, Metformin modulated ADP-dependent increase in platelet adhesion. In healthy mice, Metformin shortens bleeding time with faster thrombotic occlusion. Metformin also increased platelet mitochondrial maximal respiration and spare respiratory capacity uniquely in healthy mice., Conclusion: Metformin regulates platelet bioenergetics and ADP-mediated platelet function in DM mice which attenuates susceptibility to arterial thrombosis. Future studies will evaluate clinically relevant doses of Metformin that regulates thrombotic function in diabetic platelets.

Published
2023
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39. Liposomal Bupivacaine Decreases Intravenous Opioid Use in Patients with Hip Fracture: A Modification to a Novel Pain Protocol.

Author

Stevenson KL, Stein MK, Fryhofer GW, Looby S, Donegan D, and Mehta S

Subjects
Humans, Aged, 80 and over, Analgesics, Opioid, Bupivacaine, Anesthetics, Local, Pain, Postoperative drug therapy, Acetaminophen, Pain Management methods, Retrospective Studies, Opioid-Related Disorders, Hip Fractures, Delirium chemically induced
Abstract

Introduction: The aim of this study was to determine whether the administration of liposomal bupivacaine decreased opioid use and delirium in patients sustaining a hip fracture., Methods: A retrospective review of patients with hip fracture from September 2018 to October 2019 was performed through our institution's hip fracture registry. A liposomal bupivacaine cocktail was administered intraoperatively. Opioid requirement was determined for postoperative days 1, 2, and 3. Delirium was identified through chart review. Visual analog scale pain scores were averaged for postoperative days 1, 2, and 3. Four groups were analyzed: patients who received liposomal bupivacaine and IV acetaminophen, patients who only received IV acetaminophen, patients who only received liposomal bupivacaine, and control patients whose data were collected before this intervention. Continuous data were compared using a one-way analysis of variance or Student t-test, as applicable. Categorical data were compared using the Fisher exact test. Significance was set at P < 0.05., Results: One hundred nine patients met the inclusion criteria for the study with a mean age of 81.2 years. Eighty-two patients (75.2%) received intraoperative liposomal bupivacaine during the study year. Intravenous opioid requirement was markedly different among all four groups in all postoperative days. Oral opioid requirement and pain scores were not different between groups on any postoperative day. A notable decrease in IV opioid requirement in all postoperative days was seen in the Intervention groups (day 1 P < 0.001, day 2 P = 0.002, and day 3 P = 0.030). There existed a trend toward decreased delirium rates in the Intervention groups compared with the No Intervention group (23.9% vs. 32.8%, P = 0.272)., Conclusion: The inclusion of liposomal bupivacaine in our institution's novel pain protocol led to notable decreases in opioid requirement in all postoperative days studied with a trend toward decreased delirium rates as well., (Copyright © 2022 by the American Academy of Orthopaedic Surgeons.)

Published
2023
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40. A Novel Framework for Routine Versus Critical Communication in Surgical Education-Don't Take It Personally.

Author

Falk D, Cline P, Donegan D, and Mehta S

Subjects
Humans, Clinical Competence, Operating Rooms, Schools, Medical, Learning, Internship and Residency
Abstract

Despite their impressive academic track records and mastery of controlled classroom-based didactic learning, many orthopaedic surgery residents struggle to adjust from learning in the classroom environment in medical school to learning in the operating room as surgical residents. Instead of learning in lectures, surgical residents take on a more apprenticeship-based role with the goal of mastering technical skills in an experiential learning environment. Yet, no framework has been explicitly described in the literature to help learners make this transition. Consequently, we feel there is a need to clearly define the different learning environments and modes of communication, such that the residents can better understand how information is acquired and retained as well as how feedback is delivered in the operating room compared with more traditional spaces (eg, medical school classroom). The objectives of this summary are to (1) identify the major differences between learning in the classroom environment and the operating room and (2) introduce the concept of routine versus critical communication. We hope that by better defining the new learning environment with an emphasis on communication styles that may be encountered in this setting, learners can more easily make the transition from high-performing academicians to high-performing surgeons., (Copyright © 2022 by the American Academy of Orthopaedic Surgeons.)

Published
2023
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41. High Dose of Metformin Decreases Susceptibility to Occlusive Arterial Thrombosis in Diabetic Mice.

Author

Alvidrez RIM, Annarapu GK, Srinivasan AJ, Liu Z, Yazdani HO, Nolfi-Donegan D, Simmons RL, Shiva S, and Neal MD

Abstract

Introduction: Metformin is the most prescribed medication in Diabetes Mellitus(DM). Metformin has shown to decrease mean platelet volume, with promising antiplatelet effects. High doses of Metformin have also been associated with hypercoagulation. We hypothesize that Metformin will protect DM mice from occlusive arterial thrombus formation by altering platelet activation and mitochondrial bioenergetics., Methods: DM was developed by low dose of Streptozotocin, non-DM (healthy) mice are controls. Either vehicle or Metformin was administered twice daily via oral gavage for 7-days. Ferric chloride (FeCl3) arterial thrombosis and tail bleeding time were performed. Whole blood aggregometry, platelet activation/adhesion and mitochondrial bioenergetics were evaluated., Results: Metformin decreased susceptibility of DM mice to arterial thrombosis. Platelet bioenergetics show DM mice have increased platelet mitochondrial respiration, but no differences were observed with Metformin treatment. In non-DM (healthy) mice, Metformin modulated ADP-dependent increase in platelet adhesion. Non-DM (healthy) mice, Metformin shortens bleeding time with faster thrombotic occlusion. Metformin also increased platelet mitochondrial maximal respiration and spare respiratory capacity uniquely in non-DM (healthy) mice., Conclusion: Metformin regulates platelet bioenergetics and ADP-mediated platelet function in DM mice which attenuates susceptibility to arterial thrombosis. Future studies will evaluate clinically relevant doses of Metformin that regulates thrombotic function in diabetic platelets., Competing Interests: Competing Interest: MDN has the following financial relationships to disclose: Consultant, External Scientific Advisor for Anticoagulation Science for Janssen Pharmaceuticals (Johnson & Johnson), Research funding from Haemonetics and Instrument Laboratories, Scientific Advisory Board of Haima Therapeutics, Trauma Advisory Board, CSL Behring, and US Patent 9,072,760 TLR4 inhibitors for the treatment of human infectious and inflammatory disorders (issued to Neal, Wipf, Hackam, Sodhi). The additional authors declare that no significant conflicts of interest exist.

Published
2023

42. Anticipatory countering of motor challenges by premovement activation of orexin neurons.

Author

Donegan D, Peleg-Raibstein D, Lambercy O, and Burdakov D

Abstract

Countering upcoming challenges with anticipatory movements is a fundamental function of the brain, whose neural implementations remain poorly defined. Recently, premovement neural activation was found outside canonical premotor areas, in the hypothalamic hypocretin/orexin neurons (HONs). The purpose of this hypothalamic activation is unknown. By studying precisely defined mouse-robot interactions, here we show that the premovement HON activity correlates with experience-dependent emergence of anticipatory movements that counter imminent motor challenges. Through targeted, bidirectional optogenetic interference, we demonstrate that the premovement HON activation governs the anticipatory movements. These findings advance our understanding of the behavioral and cognitive impact of temporally defined HON signals and may provide important insights into healthy adaptive movements., (© The Author(s) 2022. Published by Oxford University Press on behalf of the National Academy of Sciences.)

Published
2022
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43. Vagus nerve stimulation drives selective circuit modulation through cholinergic reinforcement.

Author

Bowles S, Hickman J, Peng X, Williamson WR, Huang R, Washington K, Donegan D, and Welle CG

Subjects
Animals, Brain, Cholinergic Agents pharmacology, Mice, Neuronal Plasticity physiology, Nervous System Diseases therapy, Vagus Nerve Stimulation methods
Abstract

Vagus nerve stimulation (VNS) is a neuromodulation therapy for a broad and expanding set of neurologic conditions. However, the mechanism through which VNS influences central nervous system circuitry is not well described, limiting therapeutic optimization. VNS leads to widespread brain activation, but the effects on behavior are remarkably specific, indicating plasticity unique to behaviorally engaged neural circuits. To understand how VNS can lead to specific circuit modulation, we leveraged genetic tools including optogenetics and in vivo calcium imaging in mice learning a skilled reach task. We find that VNS enhances skilled motor learning in healthy animals via a cholinergic reinforcement mechanism, producing a rapid consolidation of an expert reach trajectory. In primary motor cortex (M1), VNS drives precise temporal modulation of neurons that respond to behavioral outcome. This suggests that VNS may accelerate motor refinement in M1 via cholinergic signaling, opening new avenues for optimizing VNS to target specific disease-relevant circuitry., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Published
2022
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44. Hypophysitis.

Author

Donegan D and Honegger J

Subjects
Autoimmune Hypophysitis diagnosis, Autoimmune Hypophysitis epidemiology, Autoimmune Hypophysitis etiology, Headache pathology, Hormone Replacement Therapy, Humans, Pituitary Gland pathology, Hypophysitis diagnosis, Hypophysitis epidemiology, Hypophysitis etiology
Abstract

Objective: Hypophysitis is considered a rare inflammatory disease of the pituitary gland. For a long time, primary autoimmune hypophysitis has stood out as the most relevant type of hypophysitis. However, with the advent of immunotherapy for the treatment of malignancies and identification of hypophysitis as an immune-related adverse event, hypophysitis has garnered increasing interest and recognition. Therefore, awareness, early recognition, and appropriate management are becoming important as the indication for immunomodulatory therapies broaden., Methods: In this review, we discuss the epidemiology, diagnosis, and treatment of hypophysitis with a focus on recent data and highlight subtypes of particular interest while recognizing the gaps in knowledge that remain., Results: Regardless of cause, symptoms and signs of hypophysitis may be related to mass effect (headache and visual disturbance) and hormonal disruption that warrant prompt evaluation. In the vast majority of cases, a diagnosis of hypophysitis can be made presumptively in the appropriate clinical context with radiologic findings consistent with hypophysitis and after the exclusion of other causes., Conclusion: Although subtle differences currently exist in management and outcome expectations between primary and secondary causes of hypophysitis, universally, treatment is aimed at symptom management and hormonal replacement therapy., (Copyright © 2022 AACE. Published by Elsevier Inc. All rights reserved.)

Published
2022
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45. Hypothalamic Control of Forelimb Motor Adaptation.

Author

Donegan D, Kanzler CM, Büscher J, Viskaitis P, Bracey EF, Lambercy O, and Burdakov D

Subjects
Animals, Humans, Male, Mice, Movement physiology, Orexins, Upper Extremity, Forelimb physiology, Stroke
Abstract

The ability to perform skilled arm movements is central to everyday life, as limb impairments in common neurologic disorders such as stroke demonstrate. Skilled arm movements require adaptation of motor commands based on discrepancies between desired and actual movements, called sensory errors. Studies in humans show that this involves predictive and reactive movement adaptations to the errors, and also requires a general motivation to move. How these distinct aspects map onto defined neural signals remains unclear, because of a shortage of equivalent studies in experimental animal models that permit neural-level insights. Therefore, we adapted robotic technology used in human studies to mice, enabling insights into the neural underpinnings of motivational, reactive, and predictive aspects of motor adaptation. Here, we show that forelimb motor adaptation is regulated by neurons previously implicated in motivation and arousal, but not in forelimb motor control: the hypothalamic orexin/hypocretin neurons (HONs). By studying goal-oriented mouse-robot interactions in male mice, we found distinct HON signals occur during forelimb movements and motor adaptation. Temporally-delimited optosilencing of these movement-associated HON signals impaired sensory error-based motor adaptation. Unexpectedly, optosilencing affected neither task reward or execution rates, nor motor performance in tasks that did not require adaptation, indicating that the temporally-defined HON signals studied here were distinct from signals governing general task engagement or sensorimotor control. Collectively, these results reveal a hypothalamic neural substrate regulating forelimb motor adaptation. SIGNIFICANCE STATEMENT The ability to perform skilled, adaptable movements is a fundamental part of daily life, and is impaired in common neurologic diseases such as stroke. Maintaining motor adaptation is thus of great interest, but the necessary brain components remain incompletely identified. We found that impaired motor adaptation results from disruption of cells not previously implicated in this pathology: hypothalamic orexin/hypocretin neurons (HONs). We show that temporally confined HON signals are associated with skilled movements. Without these newly-identified signals, a resistance to movement that is normally rapidly overcome leads to prolonged movement impairment. These results identify natural brain signals that enable rapid and effective motor adaptation., (Copyright © 2022 the authors.)

Published
2022
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46. Revisiting Pituitary Apoplexy.

Author

Donegan D and Erickson D

Abstract

Pituitary apoplexy (PA) is a rare clinical syndrome due to pituitary hemorrhage or infarction. It is characterized by the sudden onset of one or more of the following: severe headache, visual disturbance, nausea/vomiting, and or altered mental status. Most commonly, PA occurs in an underlying pituitary adenoma. The pathophysiology is not fully understood, but it is thought to involve elements of increased metabolic demand and/or compromise to the vasculature of the pituitary or pituitary tumor. Several risk factors have been described. Stabilization of the patient on presentation, replacement of hormonal deficiencies, and reversal of electrolyte abnormalities are the recommended initial steps in the management of patients with PA. Surgical decompression of the mass effect had been the recommended treatment for patients with PA; however, retrospective studies of patients with PA have demonstrated similar outcomes when a conservative approach is applied. This suggests that in highly selected clinical scenarios (mild visual deficit and improving symptoms), conservative management is possible. Further studies, however, are necessary to better stratify patients but are limited by the rarity of the condition and the acuity., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society.)

Published
2022
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47. Hyperphosphatemic Tumoral Calcinosis With Pemigatinib Use.

Author

Puar A, Donegan D, Helft P, Kuhar M, Webster J, Rao M, and Econs M

Abstract

Background/objective: Pemigatinib, a fibroblast growth factor receptor (FGFR) 1-3 inhibitor, is a novel therapeutic approach for treating cholangiocarcinoma when an FGFR fusion or gene rearrangement is identified. Although the most reported side effect of pemigatinib is hyperphosphatemia, tumoral calcinosis with soft tissue calcifications is not widely recognized as a complication. We report a case of patient with hyperphosphatemic tumoral calcinosis on pemigatinib., Case Report: A 59-year-old woman with progressive metastatic cholangiocarcinoma, despite receiving treatment with cisplatin and gemcitabine for 7 months, was found to have an FGFR2-BICC1 fusion in the tumor on next-generation sequencing. Pemigatinib was, therefore, initiated. Four months into the therapy, multiple subcutaneous nodules developed over the lower portion of her back, hips, and legs. Punch biopsies revealed deep dermal and subcutaneous calcifications. Investigations revealed elevated serum phosphorus (7.5 mg/dL), normal serum calcium (8.7 mg/dL), and elevated intact fibroblast growth factor-23 (FGF23, 1216 pg/mL; normal value <59 pg/mL) levels. Serum phosphorus levels improved with a low-phosphorus diet and sevelamer. Calcifications regressed with pemigatinib discontinuation., Discussion: Inhibition or deficiency of FGF-23 results in hyperphosphatemia and can lead to ectopic calcification. Pemigatinib, a potent inhibitor of FGFR-1-3, blocks the effect of FGF-23 leading to hyperphosphatemia and tumoral calcinosis as observed in our case. Treatment is aimed primarily at lowering serum phosphate levels through dietary restriction or phosphate binders; however, the regression of tumoral calcinosis can occur with pemigatinib cessation, as seen in this case., Conclusion: As the use of FGFR 1-3 inhibitors becomes more prevalent, we aim to raise attention to the potential side effects of tumoral calcinosis., (© 2022 Published by Elsevier Inc. on behalf of the AACE.)

Published
2022
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48. Pain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture Surgery : A Randomized Clinical Trial.

Author

Neuman MD, Feng R, Ellenberg SS, Sieber F, Sessler DI, Magaziner J, Elkassabany N, Schwenk ES, Dillane D, Marcantonio ER, Menio D, Ayad S, Hassan M, Stone T, Papp S, Donegan D, Marshall M, Jaffe JD, Luke C, Sharma B, Azim S, Hymes R, Chin KJ, Sheppard R, Perlman B, Sappenfield J, Hauck E, Hoeft MA, Tierney A, Gaskins LJ, Horan AD, Brown T, Dattilo J, Carson JL, Looke T, Bent S, Franco-Mora A, Hedrick P, Newbern M, Tadros R, Pealer K, Vlassakov K, Buckley C, Gavin L, Gorbatov S, Gosnell J, Steen T, Vafai A, Zeballos J, Hruslinski J, Cardenas L, Berry A, Getchell J, Quercetti N, Bajracharya G, Billow D, Bloomfield M, Cuko E, Elyaderani MK, Hampton R, Honar H, Khoshknabi D, Kim D, Krahe D, Lew MM, Maheshwer CB, Niazi A, Saha P, Salih A, de Swart RJ, Volio A, Bolkus K, DeAngelis M, Dodson G, Gerritsen J, McEniry B, Mitrev L, Kwofie MK, Belliveau A, Bonazza F, Lloyd V, Panek I, Dabiri J, Chavez C, Craig J, Davidson T, Dietrichs C, Fleetwood C, Foley M, Getto C, Hailes S, Hermes S, Hooper A, Koener G, Kohls K, Law L, Lipp A, Losey A, Nelson W, Nieto M, Rogers P, Rutman S, Scales G, Sebastian B, Stanciu T, Lobel G, Giampiccolo M, Herman D, Kaufman M, Murphy B, Pau C, Puzio T, Veselsky M, Apostle K, Boyer D, Fan BC, Lee S, Lemke M, Merchant R, Moola F, Payne K, Perey B, Viskontas D, Poler M, D'Antonio P, O'Neill G, Abdullah A, Fish-Fuhrmann J, Giska M, Fidkowski C, Guthrie ST, Hakeos W, Hayes L, Hoegler J, Nowak K, Beck J, Cuff J, Gaski G, Haaser S, Holzman M, Malekzadeh AS, Ramsey L, Schulman J, Schwartzbach C, Azefor T, Davani A, Jaberi M, Masear C, Haider SB, Chungu C, Ebrahimi A, Fikry K, Marcantonio A, Shelvan A, Sanders D, Clarke C, Lawendy A, Schwartz G, Garg M, Kim J, Caruci J, Commeh E, Cuevas R, Cuff G, Franco L, Furgiuele D, Giuca M, Allman M, Barzideh O, Cossaro J, D'Arduini A, Farhi A, Gould J, Kafel J, Patel A, Peller A, Reshef H, Safur M, Toscano F, Tedore T, Akerman M, Brumberger E, Clark S, Friedlander R, Jegarl A, Lane J, Lyden JP, Mehta N, Murrell MT, Painter N, Ricci W, Sbrollini K, Sharma R, Steel PAD, Steinkamp M, Weinberg R, Wellman DS, Nader A, Fitzgerald P, Ritz M, Bryson G, Craig A, Farhat C, Gammon B, Gofton W, Harris N, Lalonde K, Liew A, Meulenkamp B, Sonnenburg K, Wai E, Wilkin G, Troxell K, Alderfer ME, Brannen J, Cupitt C, Gerhart S, McLin R, Sheidy J, Yurick K, Chen F, Dragert K, Kiss G, Malveaux H, McCloskey D, Mellender S, Mungekar SS, Noveck H, Sagebien C, Biby L, McKelvy G, Richards A, Abola R, Ayala B, Halper D, Mavarez A, Rizwan S, Choi S, Awad I, Flynn B, Henry P, Jenkinson R, Kaustov L, Lappin E, McHardy P, Singh A, Donnelly J, Gonzalez M, Haydel C, Livelsberger J, Pazionis T, Slattery B, Vazquez-Trejo M, Baratta J, Cirullo M, Deiling B, Deschamps L, Glick M, Katz D, Krieg J, Lessin J, Mojica J, Torjman M, Jin R, Salpeter MJ, Powell M, Simmons J, Lawson P, Kukreja P, Graves S, Sturdivant A, Bryant A, Crump SJ, Verrier M, Green J, Menon M, Applegate R, Arias A, Pineiro N, Uppington J, Wolinsky P, Gunnett A, Hagen J, Harris S, Hollen K, Holloway B, Horodyski MB, Pogue T, Ramani R, Smith C, Woods A, Warrick M, Flynn K, Mongan P, Ranganath Y, Fernholz S, Ingersoll-Weng E, Marian A, Seering M, Sibenaller Z, Stout L, Wagner A, Walter A, Wong C, Orwig D, Goud M, Helker C, Mezenghie L, Montgomery B, Preston P, Schwartz JS, Weber R, Fleisher LA, Mehta S, Stephens-Shields AJ, Dinh C, Chelly JE, Goel S, Goncz W, Kawabe T, Khetarpal S, Monroe A, Shick V, Breidenstein M, Dominick T, Friend A, Mathews D, Lennertz R, Sanders R, Akere H, Balweg T, Bo A, Doro C, Goodspeed D, Lang G, Parker M, Rettammel A, Roth M, White M, Whiting P, Allen BFS, Baker T, Craven D, McEvoy M, Turnbo T, Kates S, Morgan M, Willoughby T, Weigel W, Auyong D, Fox E, Welsh T, Cusson B, Dobson S, Edwards C, Harris L, Henshaw D, Johnson K, McKinney G, Miller S, Reynolds J, Segal BS, Turner J, VanEenenaam D, Weller R, Lei J, Treggiari M, Akhtar S, Blessing M, Johnson C, Kampp M, Kunze K, O'Connor M, Looke T, Tadros R, Vlassakov K, Cardenas L, Bolkus K, Mitrev L, Kwofie MK, Dabiri J, Lobel G, Poler M, Giska M, Sanders D, Schwartz G, Giuca M, Tedore T, Nader A, Bryson G, Troxell K, Kiss G, Choi S, Powell M, Applegate R, Warrick M, Ranganath Y, Chelly JE, Lennertz R, Sanders R, Allen BFS, Kates S, Weigel W, Li J, Wijeysundera DN, Kheterpal S, Moore RH, Smith AK, Tosi LL, Looke T, Mehta S, Fleisher L, Hruslinski J, Ramsey L, Langlois C, Mezenghie L, Montgomery B, Oduwole S, and Rose T

Subjects
Aged, Analgesics therapeutic use, Anesthesia, General adverse effects, Canada, Female, Humans, Male, Pain, Pain, Postoperative drug therapy, Patient Satisfaction, Anesthesia, Spinal adverse effects, Hip Fractures surgery
Abstract

Background: The REGAIN (Regional versus General Anesthesia for Promoting Independence after Hip Fracture) trial found similar ambulation and survival at 60 days with spinal versus general anesthesia for hip fracture surgery. Trial outcomes evaluating pain, prescription analgesic use, and patient satisfaction have not yet been reported., Objective: To compare pain, analgesic use, and satisfaction after hip fracture surgery with spinal versus general anesthesia., Design: Preplanned secondary analysis of a pragmatic randomized trial. (ClinicalTrials.gov: NCT02507505)., Setting: 46 U.S. and Canadian hospitals., Participants: Patients aged 50 years or older undergoing hip fracture surgery., Intervention: Spinal or general anesthesia., Measurements: Pain on postoperative days 1 through 3; 60-, 180-, and 365-day pain and prescription analgesic use; and satisfaction with care., Results: A total of 1600 patients were enrolled. The average age was 78 years, and 77% were women. A total of 73.5% (1050 of 1428) of patients reported severe pain during the first 24 hours after surgery. Worst pain over the first 24 hours after surgery was greater with spinal anesthesia (rated from 0 [no pain] to 10 [worst pain imaginable]; mean difference, 0.40 [95% CI, 0.12 to 0.68]). Pain did not differ across groups at other time points. Prescription analgesic use at 60 days occurred in 25% (141 of 563) and 18.8% (108 of 574) of patients assigned to spinal and general anesthesia, respectively (relative risk, 1.33 [CI, 1.06 to 1.65]). Satisfaction was similar across groups., Limitation: Missing outcome data and multiple outcomes assessed., Conclusion: Severe pain is common after hip fracture. Spinal anesthesia was associated with more pain in the first 24 hours after surgery and more prescription analgesic use at 60 days compared with general anesthesia., Primary Funding Source: Patient-Centered Outcomes Research Institute .

Published
2022
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49. Insulin-Like Growth Factor 1 in the Early Postoperative Assessment of Acromegaly.

Author

Donegan D, Algeciras-Schimnich A, Ashrafzadeh-Kian S, and Erickson D

Subjects
Humans, Postoperative Period, Retrospective Studies, Acromegaly diagnosis, Acromegaly metabolism, Acromegaly surgery, Insulin-Like Growth Factor I metabolism
Abstract

Objectives: Assessment of surgical outcome in acromegaly is typically recommended at 3 to 6 months following surgery. The purpose of this study was to determine if insulin-like growth factor 1 (IGF-1) concentrations at 6 weeks were equally predictive of surgical outcomes compared with IGF-1 concentrations at 3 to 6 months postoperatively applying newer IGF-1 assays., Methods: Retrospective review of patients with newly diagnosed acromegaly who had surgery between 2013 and 2020 and had postoperative IGF-1 measured by 6 weeks and 3 to 6 months., Results: At 6 weeks, 20 (35%) of the total 57 had normal IGF-1 and became abnormal in 1 at 3 to 6 months, whereas 37 (65%) of 57 had abnormal IGF-1 concentrations at 6 weeks, which normalized in 1 patient by 3 to 6 months. In patients who changed clinical status, IGF-1 at 6 weeks was within ±0.1-fold of normal. Although a difference was seen between median IGF-1 concentrations (286 vs 267 ng/mL, P = .009) at 6 weeks and 3 to 6 months, the mean reduction was small (-19.9 ng/mL)., Conclusions: Compared with 3 to 6 months, use of IGF-1 at 6 weeks was associated with a change in clinical status in 3.5% of patients. Therefore, in most patients, IGF-1 at 6 weeks can be used to assess clinical outcome via newer assays., (© American Society for Clinical Pathology, 2021. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Published
2022
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