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2. Lessons Learned: Using the Caprini Risk Assessment Model to Provide Safe and Efficacious Thromboprophylaxis Following Hip and Knee Arthroplasty

Author

Eugene S. Krauss MD, FAAOS, FACS, MaryAnne Cronin MS, PharmD, BCPS, Nancy Dengler RN, NP, Barry G. Simonson MD, Paul Enker MD, and Ayal Segal MD

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Two of the more common potential complications after arthroplasty are venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolus (PE), and excess bleeding. Appropriate chemoprophylaxis choices are essential to prevent some of these adverse events and from exacerbating others. Risk stratification to prescribe safe and effective medications in the prevention of postoperative VTE has shown benefit in this regard. The Department of Orthopaedic Surgery at Syosset Hospital/Northwell Health, which performs over 1200 arthroplasties annually, has validated and is using the 2013 version of the Caprini Risk Assessment Model (RAM) to stratify each patient for risk of postoperative VTE. This tool results in a culling of information, past and present, personal and familial, that provides a truly thorough evaluation of the patient’s risk for postoperative VTE. The Caprini score then guides the medication choices for thromboprophylaxis. The Caprini score is only valuable if the data is properly collected, and we have learned numerous lessons after applying it for 18 months. Risk stratification requires practice and experience to achieve expertise in perioperative patient evaluation. Having access to pertinent patient information, while gaining proficiency in completing the Caprini RAM, is vital to its efficacy. Ongoing, real time analyses of patient outcomes, with subsequent change in process, is key to improving patient care.

Published
2020
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3. Behavioral Facilitation of a Transition to Energy Efficient and Low-Carbon Residential Buildings

Author

Robert A. Enker and Gregory M. Morrison

Subjects
buildings, behavioral economics, climate change, greenhouse abatement, policy instruments, regulation, Building construction, TH1-9745
Abstract

Reducing carbon emissions from the building sector is an international policy priority, as a consequence of the Paris Climate Accord obligations. The challenge for policy makers is to identify and deploy effective policy instruments targeting this sector. Examining the mechanics of policy operation in the residential sector is particularly instructive, because of the high level of building activity, diverse stakeholders, and complex policy considerations—involving both consumers and industry stakeholders. Energy policy initiatives undertaken by the European Union provide pertinent case studies; as does the operation of Australia’s national building code. The paper builds upon earlier research examining the application of socio-economic transition theory to the regulation of the building sector. Here, building policy options are examined from a behavioral economics perspective, where stakeholder actions in response to strategic initiatives are considered in socio-psychological terms. The application of behavioral economics principles to building policy has the potential to impact all of the stages of the building lifecycle, from design through construction to operation. The analysis reveals how decision-making by building industry stakeholders diverges substantially from the assumptions of conventional economics. Significant implications then arise for the framing of building sector climate and energy policies, because behavioral economics has the potential to both contribute to the critical re-appraisal of current policies, and also to provide innovative options for refining interventions at key stages in the building lifecycle.

Published
2019
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15. Podium presentations

Author

Foley, E. F., Marcello, P. W., Roberts, P. L., Murray, J. J., Coller, J. A., Veidenheimer, M. C., Schoetz, D. J., McIntyre, P. B., Pemberton, J. H., Wolff, B. G., Beart, Jr., R. W., Kelly, K. A., Dozois, R. R., Sugita, A., Fukushima, T., Harada, H., Yamamoto, M., Shimada, H., Tjandra, J. J., Fazio, V. W., Milson, J. W., Lavery, I. C., Oakley, J. R., Fabre, J. M., Karch, L. A., Bauer, J. J., Gorfine, S. R., Gelernt, I. M., Metcalf, A. M., Varilek, G., Keck, J. O., Hoffmann, D. C., Sgambati, S. A., Sardella, W. V., Marts, B. C., Longo, W. E., Vernava, III, A. M., Kennedy, D. J., Daniel, G. L., Jones, I., Venkatesh, K. S., Diamond, L. W., Larson, D. M., Ramanujam, P. J., Hicks, J. R., Ellis, C. N., Blakemore, W. S., Nathanson, S. D., Linden, M. D., Tender, P., Zarbo, R. J., Nelson, L., Bannon, J., Marks, G., Zhou, J., Mohiuddin, M., Marks, J., Pollard, C. W., Nivatvongs, S., Rojanasakul, A., Ilstrup, D. M., Speziale, N. J., Saclarides, T. J., Rubin, D. B., Szeluga, D. J., Morgado, P. J., Gomez, L. G., Morgado, Jr., P. J., Neto, J. A. Reis, Quilici, F. A., Cordeiro, F., Reis, Jr., J. A., Nitecki, S., Benn, P., Sarr, M. G., Weiland, L. H., Elhadad, A., Rouffet, F., Baillet, P., Akasu, T., Moriya, Y., Hojo, K., Sugihara, K., Oshima, H., Liu, S. K., Church, J. M., Kirkpatrick, J. R., Danielson, C. L., Dominguez, J. M., Jakate, S. M., Savin, M. H., Altringer, W. J., Lee, C. S., Spencer, M. P., Madoff, R. D., Barrett, R. C., Oster, M. A., Durdey, P., Stein, B. L., Staniunas, R. J., Grewal, H., Guillem, J. G., Quan, S., Enker, W. E., Cohen, A. M., van Tets, W. F., Kuijpers, H. C., Kerner, B. A., Wise, Jr., W. E., Golub, R. W., Arnold, M. W., Aguilar, P. S., Pernikoff, B. J., Eisenstat, T. E., Rubin, R. J., Oliver, G. C., Salvati, E. P., Lunniss, P. J., Sultan, A. H., Barker, P. G., Armstrong, P., Bartram, C. I., Phillips, R. K. S., Schouten, W. R., Briel, J. W., Auwerda, J. J. A., Harnsberger, J. R., Robbins, P. L., Brabbee, G. W., Ryhammer, A. M., Bek, K. M., Hanberg-Sørensen, F., Laurberg, S., Hoff, S. D., Bailey, H. R., Butts, D. R., Max, E., Smith, K. W., Zamora, L. F., Skakun, G. B., Khanduja, K. S., Lee, H., Beart, R. W., Spencer, R., Wiseman, J. S., Senagore, A. J., Bain, I. M., Oliff, J., Min, L., Neoptolomos, J., Keighley, M. R. B., O'Kelly, T. J., Davies, J., Brading, A. F., Mortensen, N. J. McC, Park, J. -G., Han, H. J., Kang, M. S., Nakamura, Y., Goldberg, G. S., Orkin, B. A., Smith, L. E., Fleshner, P. R., Freilich, M. I., Meagher, A. P., Adams, W. J., Lubowski, D. Z., King, D. W., Moran, M., Opelka, F., Timmcke, A., Hicks, T., Gathright, Jr., J. B., Leu, S. Y., Hsu, H., Dean, P. A., Ramsey, P. S., Nelson, H., Philpott, G., Siegel, B., Schwarz, S., Fleshman, J., Welch, M., Connett, J., Buie, W. D., Johnson, D. R., Heine, J. A., Wong, W. D., Rothenberger, D. A., Goldberg, S. M., Shafik, A., MacDonald, A., Craig, J. W., Finlay, I. G., Baxter, J. N., Muir, T. C., Parikh, S., Gold, R. P., Gottesman, L., Annibali, R., Öresland, T., Hallgren, T., Fasth, S., Hultén, L., Farouk, R., Duthie, G. S., MacGregor, A. B., Bartolo, D. C. C., Williamson, M. E. R., Lewis, W. G., Holdsworth, P. J., Hall, N., Finan, P. J., Johnston, D., Seow-Choen, F., Goh, H. S., Motson, R. W., Walsh, C. J., Mooney, E., Yamashita, H. J., Wise, W. E., Hartmann, R. F., Seccia, M., Menconi, C., Ghiselli, G., Cavina, E., Salomon, M. C., Ferrara, A., Larach, S. W., Williamson, P. R., Bass, E. M., Orsay, C. P., Firfer, B., Ramakrishnan, V., Abcarian, H., Bufo, A. J., Feldman, S., Daniels, G. A., Lieberman, R. C., Loder, P. B., Kamm, M. A., Nicholls, R. J., Kum, C. K., Ngoi, S. S., Goh, P. M. Y., Tekant, Y., Isaac, J. R., Gerstle, J. T., Kauffman, G. L., and Koltun, W. A.

Published
1993
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16. American Society of Colon and Rectal Surgeons 91st Annual Convention Podium and Poster abstracts: June 7–12, 1992 San Francisco, CA

Author

Lechner, P., Lind, P., Binter, G., Golub, R. W., Kerner, B. A., Wise, Jr., W. E., Meesig, D. M., Hartmann, R. F., Khanduja, K. S., Sayre, J. W., Aguilar, P. S., Guillem, J. G., Forde, K. A., Treat, M. R., Neugut, A. I., O'Toole, K. M., Diamond, B. E., Kewenter, J., Brevinge, H., Haglind, E., Limberg, B., Elles, C. N., Boggs, W. H., Slagle, G. H., Cole, P. A., Coyle, D. J., Smith, L. E., Orkin, B., Saclarides, T. J., Sheridan, W. G., Lowndes, R. H., Young, H. L., Wong, W. D., Rothenberger, D. A., Bartolo, D. C. C., Wexner, S. D., Ger, G. C., Jorge, J. M. N., Lee, E., Nogueras, J. J., Jagelman, D. G., McKenna, K., Koltun, W. A., Bute, B., Lichliter, W., Le, T., Timmcke, A., Gathright, J. B., Mascagni, D., Hojo, K., Moriya, Y., Sugihara, K., Di, G., Zenni, G. C., Abraham, K., Dobrin, P. B., Harford, F. J., Suzuki, K., Gunderson, L., Devine, R. M., Dozois, R. R., Cavaliere, F., Pemberton, J. H., Fazio, V., Cosimelli, M., Beart, R. W., Giannarelli, D., Moran, M., Ramos, A., Rothenberger, D., Goldberg, S., Antonenko, D., Heymen, S., Gulledge, A. D., Jakate, S., Saclarides, T., Heine, J. A., Williams, J. G., VanBergen, E. H., Buie, W. D., Goldberg, S. M., Davies, N., Yates, J., Jenkins, S. A., Taylor, B. A., Bapat, B., Stern, H., Berk, T., Parker, J., Ray, P. N., McLeod, R., Cohen, Z., Rowe, J. K., Zera, R. T., Madoff, R. D., Bubrick, M. P., Roberts, J. C., Johnston, G. R., Fenney, D. A., Farouk, R., Duthie, G. S., McCue, J. L., Phillips, R. K. S., Viamonte, M., Cole, J., Gottesman, L., Solomon, M. J., McLeod, R. S., Kern, K., Jensen, L. L., Lowry, A. C., Vernava, III, A. M., Longo, W. E., Daniel, G. L., Ehrenpreis, E., Stone, J. M., Cosman, B. C., Wolfe, V. A., Nino-Murcia, M., Perkash, I., Marcello, P. W., Roberts, P. L., Schoetz, Jr., D. J., Murray, J. J., Coller, J. A., Veidenheimer, M. C., Keighley, M. R. B., Grobler, S. P., Hosie, K. B., Schmitt, S. L., James, K., Lucas, F., Peck, Donald A., Ferrara, A., Grotz, R. L., Perry, R. E., Hanson, R. B., Lewis, W. G., Holdsworth, P. J., Sagar, P. M., Johnston, D., Perry, T. G., Strong, S. A., Fazio, V. W., Lavery, I. C., Oakley, J. R., Church, J. M., Milsom, J. W., Fozard, J. B. J., Nelson, H., Schneebaum, S., Arnold, M. W., Young, D., LaValle, G. J., Petty, L., Berens, A., Mojizisik, C., Martin, E. W., Hase, K., Shatney, C. H., Trollope, M., Johnson, D., Vierra, M., Deutsch, A. A., Tulchinsky, H., Nudelman, I., Gutman, H., Reiss, R., Taylor, Brian M., Araujo, A., Bleday, R., Jessurun, J., Heine, J., Rosen, Les, Sipe, Paul, Riether, Robert, Stasik, John, Sheets, James, Khubchandani, Indru, Reiter, W., Friedberg, G., Morey, G., Goldstein, E., Williamson, P., Larach, S., Senagore, A. J., Luchtefeld, M. A., MacKeigen, J. M., Mazier, W. P., Wengert, T., Ott, M. T., Bailey, H. R., Hartendorp, P., Dailey, T. H., Church, J. C., Johansen, O. B., Daniel, N., Korst, M., Kuijpers, H. C., Pena, J. P., Christenson, C. E., Balcos, E. G., Lewis, W., Mitchell, C., MacFie, J., Hildebrandt, U., Ecker, K. W., Kraus, J., Schmid, T., Feifel, G., Tjandra, J. J., Scoggin, Steve, Frazee, Richard C., Ambroze, Jr., W. L., Nezhat, C., Pennington, E., Nezhat, F., Stolfi, V. M., Thorson, A. G., Falk, P. M., Fitzgibbons, Jr, R. J., Luukkonen, P., Järvinen, H. J., James, E., Paty, P. B., Enker, W. E., Cohen, A. M., Lauwers, G. Y., Saad, R., Birnbaum, E., DeVos, W., Fry, R., Kodner, I., Fleshman, J., Cali, R. L., Pitsch, R. M., Blatchford, G. J., Christensen, M. A., Schroeder, T. K., Easley, K. A., Ellis, C. N., Cheape, J. D., Hull, T. L., Salanga, V., Kokoszka, Joseph, Andrianopoulos, Georgia, Nelson, Richard, Abcarian, Herand, Kumar, D., Benson, M. J., Roberts, J., Martin, J. E., Swash, M., Wingate, D. L., Williams, N. S., Orkin, B. A., Emsellem, H., Dent, John, Tissaw, M. A., Shafik, A., Abel, M. E., Chiu, Y. S. Y., Russell, T. R., Volpe, P. A., Casillas, G. L., Mashas, W. E., Eastman, D. A., Grace, R. H., Anderson, J. M., Hacker, K., Heryer, J., Conner, W., Rubin, R., Eisenstat, T., Salvati, E., Oliver, G., Duberman, E., Simmang, C. L., Fry, R. D., Kodner, I. J., Fleshman, J. W., Corman, M. L., Galandiuk, S., Weiner, G. J., Kahn, D., Mitchell, E., Abdel-Nabi, H., Block, G. E., Mannella, E., Tedesco, M., Anza, M., Civalleri, D., Di Tora, P., Capussotti, L., Morandi, G. B., Tirelli, C., Da Pian, P. P., Cortesi, E., Ruggeri, E., Fitzgerald, S. D., Davis, Faith, Bowen, Phyllis, Sutter, Eileen, Kikendall, Walter, McGannon, E., Brantley, P. A., Czyrko, C., Falardeau, C., Trepashko, Don, Skosey, John, Michelassi, F., Staniunas, R. J., Vignati, P. V., Beck, D. E., Karulf, R., Roettger, R., Braidt, J., Ruoff, K., Ackroyd, F., Shellito, P., Goh, H. S., Lin, L. W., Edwards, E., Farmer, J., Walters, C. A., Hyman, N. H., Hebert, J. C., Richman, Irving M., Staren, E. D., Sessions, S. C., Scoma, R. S., Clements, B., Smink, Jr., R. D., Arai, K., Sugita, A., Yamazaki, Y., Harada, H., Fukushima, T., Armstrong, D. N., Ballantyne, G. H., Sillin, L. F., Davie, R. J., Harding, L. K., Birch, N. J., Yamanouchi, T., Bayer, I., Mitmaker, B., Gordon, P. H., Wang, E., Kynaston, H., Edelstein, P. S., Thompson, S. M., Davies, R. J., Farmer, K. C. R., Oliver, S. E., Spigelman, A. D., Bennett, P., O'Kelly, T. J., Brading, A. F., Mortensen, N. J., Paul, P., McGannon, E. M., Huth, P., Hull-Boiner, S., Pezim, M. E., Johnson, H. W., Gillespie, K. D., Willard, P., Owen, D. A., Ramsey, P. S., Leu, S. Y., Hsu, H., Al-Humadi, Adil H., Eisman, E., Tries, J., Gupta, N. C., Frick, M. P., Boman, B. M., Franceschi, D., Eckhauser, M. L., Pritchard, T., Konsten, J., Baeten, C. G. M. I., Havenith, M. G., Soeters, P. B., Lau, P. W. K., Lorentz, T. G., Wong, J., and The III In-CYT-103 Immunoscintigraphy Study Group

Published
1992
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18. Abstracts

Author

Rosen, L., Reed, J., Ufberg, D., Thorburn, H., Carter, K., Goldberg, J., Finlay, I. G., Church, J. M., Hill, G. L., Carter, F. M., Cohen, Z., McLeod, R. S., Bauer, J. J., Sher, M. E., Gelernt, I. M., Crim, R. W., Fazio, V. W., Lavery, I. C., Williams, J. G., Nemer, F. D., Rothenberger, D. A., Goldberg, S. M., Hyman, N. H., Tuckson, W. B., Deutsch, A. A., Gregoire, R., Cullen, J., Johnson, G. P., Wolff, B. G., Koltun, W., Schoetz, Jr., D. J., Roberts, P. L., Murray, J. J., Coller, J. A., Veidenheimer, M. C., Keighley, M. R. B., Hosie, K., Sakaguchi, M., Tudor, R., Kmiot, W., Ambroze, Jr., W. L., Dozois, R. R., Pemberton, J. H., Kelly, K. A., Wiltz, O., Hashmi, H., Fucini, C., Thayer, M. L., Madoff, R. D., Jacobs, D. M., Bubrick, M. P., Galandiuk, S., Tsao, J., Ilstrup, D. M., Duthie, G. S., Bartolo, D. C. C., Miller, R., Pinho, M., Kunin, J. D., Fleshman, J. W., Kodner, I. J., Fry, R. D., Wexner, S. D., Jagelman, D. G., Corredor, C., Salanga, V., Scholefield, J. H., Whatrup, C., Talbot, I. C., Northover, J. M. A., Sonnex, C., Safavi, A., Gottesman, L., Dailey, T., Moenning, S., Nightengale, S., Simonton, T., Huber, P., Odom, C., Kaplan, E., Strong, S. A., Milsom, J. W., Taylor, C. W., Cho, C. C., Stewart, W. R. C., Hartmann, R. F., Khanduja, K. S., Aguilar, P. S., Rahman, S. M., Arnold, M. W., Caushaj, P., Viratyosin, S., French, T., Madoff, R., Karamjit, S., Meesig, D. M., Macleod, C. A. H., Balcos, E. G., Buls, J. G., Nelson, H., Donohue, J. H., McKean, D. J., Leu, S. Y., Wang, S. R., Hsu, H., Ramanujam, P. S., Alberts, D. S., Clark, L., Ritenbaugh, C., Rowley, S., Kane, N., Jones, C., Davies, A., Baker, P., Neoptolemos, J. P., Devereux, D. F., Robertson, F. M., Spain, D. A., Cance, W. G., Cohen, A. M., Sigurdson, E. R., Enker, W. E., Konishi, F., Yasuda, Y., Ochiai, S., Kanazawa, K., Davis, M., Medina, V., Miller, D., Fielding, L. P., Prats, I., Berman, M., West, B., Savoca, P. E., Ballantyne, G. H., Flannery, J. T., Modlin, I. M., Tsukada, K., Jagelman, D. A., McGannon, E. M., Schroeder, T., Sakamoto, G. D., MacKeigan, J. M., Opelka, F., Timmcke, A., Gathright, J. B., Hicks, T., Ray, J., McKee, C. C., Ragland, J. J., Myers, J. O., Christie, J. P., Marrazzo, III, J., Flemming, F. X., Longo, W. E., Pollard, C. W., Nivatvongs, S., Rojanasakul, A., Jetmore, A. B., Baker, J., Wiltz, O. H., McKee, R. F., Lauder, J., Poon, F., Aitchison, M., Fleshman, James W., Dreznik, Zeev, Kodner, Ira J., Fry, Robert D., Kerner, B. A., Labow, S., Hoexter, B., Moseson, M., Cheape, J. D., Bowinkelman, K., Dziki, A. J., Malthaner, R. A., Harmon, J. W., Saini, N., Duncan, M. D., Fernicola, M. T., Fischer, B. A., Hakki, F. Z., Trad, K. S., Ugarte, R., Senagore, A. J., Mazier, W. P., Kilbride, M., Herrera, L., Goumas, W., Petrelli, N., Bailey, H. R., Huval, W. V., Max, E., Smith, K. W., Marks, G., Mohiuddin, M., Basile, M., Eitan, A., Wolff, B., Dozois, R., Devine, R., Beart, R., Kelly, A., Unti, J. A., Orsay, C. P., Pearl, R. K., Nelson, R. L., Duarte, B., Prasad, M. L., Abcarian, H., Senagore, A., Milson, J. W., Strong, S., Walshaw, R. K., Chaudry, I. H., Hojo, K., Sugihara, K., Katunuma, K., Vernava, A., Beart, R. W., Stewart, J., Diament, R. H., Salter, M., Brennan, T. G., Sheikh, F., Khubchandani, I. T., Miyajima, N., Uematsu, Y., Kodaira, S., Teramoto, T., Orrom, W. J., Duthie, G., Corne, H., Blatchford, G. J., Perry, R. E., Christensen, M. A., Thorson, A. G., Dreznik, Zeev, Wong, W. D., Jensen, L. L., Lee, K. H., Yoon, Choong, Joo, H. Z., Levien, D. H., Gibbons, S., Begos, D., Byrne, D. W., Gordon, P. H., Bégin, L. R., Mitmaker, B., Saclarides, T., Bhattacharyya, A., Britton, C., Stone, J. M., Lowry, A. C., Moran, M., Launer, D. P., McReynolds, D. G., Eastman, A. B., Peck, J. J., Rozycki, G. S., Ramanujam, Paravasthu S., Bellapravalu, Sharad, Venkatesh, Kurakurachi S., Griffin, Kathleen M., Vernava, A. M., Beckman, R., Andrus, C., Johnson, F., Herrmann, V., Kaminski, D. L., Wetter, L. A., Dinneen, M., Levitt, M., Motson, R. W., Rohrer, D. A., Bapna, M. S., Rotstein, L. E., Radhakrishnan, Jayant, Shrader, Charisse, Ravo, B., Frattaroli, F. M., Reggio, D., Litchy, W. J., Hanson, R. B., Morgado, Pedro J., Alfaro, Rodrigo, Alfonzo, Rafael, Vachon, D. A., Oliver, G. C., Eisenstat, T. E., Salvati, E. P., Rubin, R. J., Clay, R. P., Kumar, Sanath, Guillem, J. G., Levy, M. F., Hsieh, L. L., Johnson, M. D., Forde, K. A., Weinstein, I. B., Bilchik, A. J., Fleming, F. X., Pernikoff, B. J., Goldenring, J. R., Fozard, J. B., Lowndes, R. H., Young, H. L., Sackier, J., Leite, J. F. M. S., Fausto-Pontes, Martins, M. I., Kmiot, W. A., Youngs, D. J., Harding, L. K., Hesselwood, S. R., Smith, N., Hartley, M. G., Hudson, M. J., Hill, M. J., Gent, A. E., Grace, R. H., Swarbrick, E. T., Hellier, M. D., Procaccino, J. A., Oakley, J. R., Flanagan, Jr., R. A., Lapos, L., Riether, R. D., Stasik, J. J., Trostle, D. R., Sheets, J. A., Ferrara, A., Armstrong, D. N., Bjorck, S., McMillen, M. A., Nicholson, J. D., Halleran, D. R., Trivisonno, D. P., Ziegler, J. A., Lott, J., Saleeby, R., Sullivan, T., and Nelson, R.

Published
1990
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21. Invited editorial

Author

Enker, Warren E., Young-Fadok, Tonia M., Wolff, Bruce G., Nivatvongs, Santhat, Metzger, Philip P., and Ilstrup, Duane M.

Published
1998
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23. Attitudinal and Normative Variables as Predictors of Cheating Behavior.

Author

Enker, Myrna S.

Abstract

Predictors of cheating behavior in American and Israeli society were studied. Predictors in American society were attitudes, normative beliefs, or both together; friends and classmates were stronger influences than families. In Israeli society, normative beliefs were the significant predictors, and family norms influenced cheating behavior. (VM)

Published
1987

25. Monoclonal antibodies and immobilized antibodies

Author

Linhardt, Robert J., Abell C. W., Denney R. M., Altrock B. W., Auerbach R., Bernal S. D., Canfield R. E., Ehrlich P. H., Moyle W. R., Chan T. S., Chang T. W., Chang N. T., Cidlowski J. A., Viceps M. D., Cote R. J., Morrissey D. M., Houghton A. N., Beattie E. J., Oettgen H. F., Old L. J., Croce C. M., Cubicciotti R. S., Karu A. E., Krauss R. M., Cullor J. S., Deutsch A., Brandwein H., Platt H., Hunter D. M., Dubitsky A., Durham S. M., Dolbeare F. A., Gray J. W., Dreesman G. R., Kendall C. E., Egrie J. C., Frackelton A. R., Eisen H. N., Ross A. H., Gay S., Geirnaert G., Geltosky J. E., Goldberg E. H., Goldwasser E., Kavinsky C., Weiss T. L., Gratzner H. G., Hampar B., Zweig M., Showalter S. D., Handley H. H., Glassy M. C., Hagiwara Y., Hagiwara H., Huang C. M., Cohen S. N., Hughes J. V., Scolnick E. M., Tomassini J. E., Jefferis R., Steensgaard J., Kaplan H. S., Teng N. N. H., Earn K. S., Calvo R. F., Kass L., Kettman J. R., Norgard M. V., Khazaeli M. B., Beierwaltes W. H., England B. G., Kung P. C., Goldstein G., Lanier L., Phillips J., Lanier L., Warner N. L., Larrick J. W., Raubitschek A. R., Truitt K. E., Lazarus H., Schwaber J. F., Lewicki J., Lewis C., Olander J. V., Tolbert W. R., Milford E. L., Carpenter C. B., Paradysz J. M., Mosher D. F., Mulshine J. L., Minna J. D., Murray K. A., Neville D. M., Youle R. J., Neville D. M., Youle R. J., Nicolson M., Pastan I., Willingham M. C., Fitzgerald D. J., Pucci A., Smithyman A. M., Slade M. B., French P. W., Wijffels G., Pukel C. S., Lloyd K. O., Travassos L. R., Dippold W. G., Oettgen H. F., Old L. J., Reckel R. P., Harris J. L., Wellerson R., Shaw S. M., Kaplan P. M., Reinherz E. L., Schlossman S. F., Mener S. C., Sakamoto J., Cordon C. C., Friedman E., Finstad C. L., Enker W. E., Melamed M. R., Lloyd K. O., Oettgen J. F., Old L. J., Scannon P. J., Spitler L. E., Lee H. M., Kawahata R. T., Mischak R. P., Schlom J., Colcher D., Nuti M., Hand P. H., Austin F., Shockman G. D., Jackson D. E., Wong W., Steplewski Z., Koprowski H., Herlyn M., Strand M., Trowbridge I. S., Urdal D. L., March C. J., Dower S. K., Wands J. R., Zurawski V. R., White C. A., Dulbecco R., Allen W. R., Arnold E. C., Flasher M., Freedman H. H., Heath T. D., Shek P., Papahadjopoulos D., Ikeda M., Sakamoto S., Suzuki K., Kuboyama M., Harada Y., Kawashiri A., Takahashi E., Lee H. S., Margel S., Neville D. M., Youle R. J., Nowinski R. C., Hoffman A. S., Peterson J. W., Platt K. B., Reed D. E., Real F. X., Mattes M. J., Houghton A. N., Livingston P. O., Lloyd K. O., Oettgen H. F., Old L. J., Rembaum A., Yen R. C. K., Rosenstein R., and Schneider B.

Published
1987
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26. Resection of the liver for colorectal carcinoma metastases: A multi-institutional study of long-term survivors

Author

Hughes, Kevin S., Rosenstein, Rebecca B., Songhorabodi, Sate, Adson, Martin A., Ilstrup, Duane M., Fortner, Joseph G., Maclean, Barbara J., Foster, James H., Daly, John M., Fitzherbert, Diane, Sugarbaker, Paul H., Iwatsuki, Shunzaboro, Starzl, Thomas, Ramming, Kenneth P., Longmire, Jr., William P., O'Toole, Kathy, Petrelli, Nicholas J., Herrera, Lemuel, Cady, Blake, McDermott, William, Nims, Thomas, Enker, Warren E., Coppa, Gene F., Blumgart, Leslie H., Bradpiece, Howard, Urist, Marshall, Aldrete, Joaquin S., Schlag, Peter, Hohenberger, Peter, Steele, Jr., Glenn, Hodgson, W. John, Hardy, Thomas G., Harbora, Denise, McPherson, T. Alexander, Lim, Christoper, Dillon, Daniel, Happ, Richard, Ripepi, Phillip, Villella, Edward, Smith, William, Rossi, Ricardo L., Remine, Stephen G., Oster, Mary, Connolly, David P., Abrams, Jerome, Al-Jurf, Adel, Hobbs, K. E. F., Li, Michael K. W., Howard, Ted, and Lee, Emonuel

Published
1988
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30. Erratum to Thrombosis prophylaxis in surgical patients using the Caprini Risk Score' [Current Problems in Surgery 59/11 (2022) 101221].

Author

Wilson, Spencer, Chen, Xiaolan, Cronin, Mary Anne, Dengler, Nancy, Enker, Paul, Krauss, Eugene S., Laberko, Leonid, Lobastov, Kirill, Obi, Andrea T., Powell, Chloé A., Rosenkranz, Pamela, Schastlivtsev, MEdIlya, Segal, Ayal, Simonson, Barry, Siracuse, Jeffrey, Wakefield, Thomas W., McAneny, David, and Caprini, Joseph A.

Published
2023
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33. In Brief.

Author

Wilson MD, Spencer, Chen MD, Xialan, Cronin, MaryAnne, Dengler, Nancy, Enker MD, Paul, Krauss MD, Eugene S., Laberko, Leonid, Lobastov, Kirill, Obi MD, Andrea T., Powell MD, Chloé A., Schastlivtsev, Ilya, Segal MD, Ayal, Simonson MD, Barry, Siracuse MD, Jeffrey, Wakefield MD, Thomas W., McAneny MD, David, and Caprini MD, Joseph A.

Published
2022
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35. Artificial Disc Replacement

Author

Enker, P., primary, Steffee, A., additional, Mcmillin, C., additional, Keppler, L., additional, Biscup, R., additional, and Miller, S., additional

Published
1993
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36. IN RE A: SEVERING THE CONJOINED TWINS IN JEWISH LAW

Author

Enker, Arnold N.

Abstract

AbstractIn re Awas decided by the English courts in 2000. Twin girls, named Jodie and Mary for purposes of the decision, were born joined together at their lower extremities. Jodie's heart and lungs were more or less healthy. But Mary's were insufficiently developed and could not provide her with the flow of blood and oxygen needed to survive. However, the girls shared a single circulatory system so that Jodie's heart pumped blood that flowed through both their bodies. In this manner, Jodie's heart and lungs kept Mary alive. According to the doctors, this situation could continue for a period of three to six months, or a bit longer, at the most. As the girls grew, Jodie would be unable to provide sufficient blood and oxygen to support both Mary and herself. Both would die. The doctors recommended surgical separation of the two girls. Mary would necessarily die “within minutes,” being cut off from her source of sustenance. Jodie would have a good chance of surviving. The legal issue presented was whether the doctors may perform the surgery that would cause Mary's death. At issue were questions concerning the scope of self-defense and necessity. In the course of the Court's opinions, brief reference was made to Jewish law. This article considers the Jewish law sources that bear on these issues.

Published
2014
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40. Gastrointestinal Tract Recovery in Patients Undergoing Bowel Resection: Results of a Randomized Trial of Alvimopan and Placebo With a Standardized Accelerated Postoperative Care Pathway

Author

Ludwig, Kirk, Enker, Warren E., Delaney, Conor P., Wolff, Bruce G., Du, Wei, Fort, John G., Cherubini, Maryann, Cucinotta, James, and Techner, Lee

Abstract

OBJECTIVE To investigate the efficacy and safety of alvimopan, 12 mg, administered orally 30 to 90 minutes preoperatively and twice daily postoperatively in conjunction with a standardized accelerated postoperative care pathway for managing postoperative ileus after bowel resection. DESIGN, SETTING, AND PATIENTS This multicenter, randomized, placebo-controlled, double-blind, phase 3 trial enrolled adult patients undergoing partial bowel resection with primary anastomosis by laparotomy and scheduled to receive intravenous, opioid-based, patient-controlled analgesia. A standardized accelerated postoperative care pathway including early ambulation, oral feeding, and postoperative nasogastric tube removal was used to facilitate gastrointestinal (GI) tract recovery in all of the patients. MAIN OUTCOME MEASURES The primary end point was time to GI-2 recovery (toleration of solid food and first bowel movement). Secondary end points included time to GI-3 recovery (toleration of solid food and first flatus or bowel movement), hospital discharge order written, and actual hospital discharge. Postoperative length of hospital stay based on calendar day of hospital discharge order written, opioid consumption, and overall postoperative ileus–related morbidity were recorded. RESULTS Alvimopan, 12 mg, was well tolerated and significantly accelerated GI-2 recovery, GI-3 recovery, and actual hospital discharge compared with a standardized accelerated postoperative care pathway alone (hazard ratio = 1.5, 1.5, and 1.4, respectively; P < .001 for all). Time to hospital discharge order written as measured by hazard ratio (1.4) and by postoperative calendar days (mean for alvimopan, 5.2 days; mean for placebo, 6.2 days) was also accelerated. Opioid consumption was comparable between groups, and alvimopan was associated with reduced postoperative ileus–related morbidity compared with placebo. CONCLUSIONS Alvimopan, 12 mg, administered 30 to 90 minutes before and twice daily after bowel resection is well tolerated, accelerates GI tract recovery, and reduces postoperative ileus–related morbidity without compromising opioid analgesia. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00205842Arch Surg. 2008;143(11):1098-1105--

Published
2008
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42. High-dose-rate intraoperative irradiation: Current status and future directions

Author

Hu, Kenneth S., Enker, Warren E., and Harrison, Louis B.

Abstract

Intraoperative irradiation (IORT) refers to the delivery of a single high dose of radiation therapy at the time of surgery when the tumor bed can be precisely defined and adjacent normal tissue maximally protected. It can be effectively delivered using either electrons (IOERT) or photons produced from a high-dose-rate gamma emitting radioisotope (HDR-IORT) and has been explored primarily for locally advanced or recurrent tumors at high risk for local failure despite extensive resection and full dose external beam radiation. With coordinated multidisciplinary interaction, IORT can be integrated in a combined-modality setting without undue additional toxicity. The purpose of this review will be to summarize the growing HDR-IORT experience in the treatment of various cancers, to compare its efficacy and toxicity vis a vis the IOERT data, and to discuss future trials as well as new areas of potential application.

Published
2002
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43. Current status of total mesorectal excision and autonomic nerve preservation in rectal cancer

Author

Murty, Murali, Enker, Warren E., and Martz, Joseph

Abstract

Two decades have passed since the late 1970s, which witnessed the introduction of total mesorectal excision (TME)-based operations for rectal cancers on both sides of the Atlantic. Since the introduction of TME, clinical experience has been reported widely in the form of single- and multisurgeon reports from wide geographic regions with multiple participants, and from specialty services with narrow focus and high levels of expertise. All of these published results conclude that in comparison with conventionally practiced blunt surgery for rectal cancer, TME-based (i.e., anatomically correct, sharply performed) operations are associated with significantly lower rates of pelvic (local) recurrences, a significantly higher rate of survival, and significantly lower long-term morbidity. The latter is accomplished through dramatically higher rates of sphincter preservation, and the preservation of both sexual and urinary functions. Overall, there is a remarkable similarity in the clinical results that have been reported from diverse centers. TME now forms the basis of large randomized clinical trials in which the role of adjuvant therapy is being reexamined. The current status of TME is reviewed, and the authors’ clinical results of a consecutive series of 544 TME-based operations performed through 1998 are updated. Semin. Surg. Oncol. 19:321–328, 2000. © 2000 Wiley-Liss, Inc.

Published
2000
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44. Planes of sharp pelvic dissection for primary, locally advanced, or recurrent rectal cancer<FNR HREF="fn1"></FNR><FN ID="fn1">This work is supported in part by the Sophie Z. Gore Foundation.</FN>

Author

Enker, Warren E., Kafka, Nicole J., and Martz, Joseph

Abstract

In the design of operations for rectal cancers, the focus is often on circumventing the local extent of disease and leaving the pelvis free of cancer. The local extent of disease may range from minimal intramural invasion to the direct extension of a primary tumor to pelvic sidewall structures, e.g., the internal iliac vessels. In the absence of distant spread, understanding the planes of pelvic anatomy may allow the knowledgeable surgeon to cure patients who would otherwise be declared unresectable. We present the four planes (and one rare situation) available for sharp dissection which allow for the resection of all but a few cases of locally advanced disease. Semin. Surg. Oncol. 18:199–206, 2000. © 2000 Wiley-Liss, Inc.

Published
2000
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45. Improved survival and local control after total mesorectal excision or D3 lymphadenectomy in the treatment of primary rectal cancer: an international analysis of 1411 patients

Author

Havenga, K., Enker, W. E., Norstein, J., Moriya, Y., Heald, R. J., Houwelingen, H. C. van, and Velde, C. J. H. van de

Abstract

Aims: Improved local control and survival in the treatment of rectal cancer have been reported after total mesorectal excision and after extended lymphadenectomy. Comparison of published results is difficult because of differences in patient populations and definitions. We compared three series of patients who underwent standardized surgery [i.e. total mesorectal excision (TME) or D3 lymphadenectomy] with patients who underwent conventional surgery, using actual patient data and uniform definitions. Methods: TME was performed at Memorial Sloan-Kettering Cancer Center, New York, USA (n=254) and the North Hampshire Hospital, Basingstoke, UK (n=204). D3 lymphadenectomy was performed at the National Cancer Center, Tokyo (n=233). Conventional surgery was used in hospitals in Norway (n=366) and in hospitals of the Comprehensive Cancer Center West, The Netherlands (n=354). Only patients with a curatively resected primary TNM Stage II or Stage III rectal cancer within 12 cm from the anal verge were included. Results: Five-year overall survival and cancer-specific survival were 62–75% and 75–80%, respectively, in the standardized surgery groups and 42–44% and 52%, respectively, in the conventional surgery groups. Local recurrence rates ranged from 4 to 9% in the standardized surgery groups and 32–35% in the conventional surgery groups. Conclusions: A 30% survival difference and 25% local recurrence difference is not likely to be caused by the shortcomings which are inherent in a non-randomized study: selection bias, assessment variability or stage migration. This study suggests that standardized surgery gives superior survival and local control when compared to conventional surgery. Copyright 1999 W.B. Saunders Company Ltd

Published
1999
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46. Anatomical basis of autonomic nerve-preserving total mesorectal excision for rectal cancer

Author

Havenga, K, De Ruiter, M C, Enker, W E, and Welvaart, K

Abstract

Total mesorectal excision with autonomic nerve preservation for rectal cancer is based on the anatomy of the mesorectum and of the pelvic autonomic nerves. Cadaver dissections were performed to describe the relationship between these structures. Between the rectum and the sacrum a retrorectal space can be developed, lined anteriorly by the visceral leaf and posteriorly by the parietal leaf of the pelvic fascia. The hypogastric nerve runs anterior to the visceral fascia, from the sacral promontory in a laterocaudad direction. The splanchnic sacral nerves originate from the sacral foramina, posterior to the parietal fascia, and run caudad, laterally and anteriorly. After piercing the parietal layer of the pelvic fascia, approximately 4 cm from the midline, the sacral nerves run between a double layer of the visceral part of the pelvic fascia. The relationship between the hypogastric nerves, the splanchnic nerves and the pelvic fascia was comparable in all six specimens examined.

Published
1996
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47. Potency, Cure, and Local Control in the Operative Treatment of Rectal Cancer

Author

Enker, Warren E.

Abstract

• Impotence due to parasympathetic nerve injury is one of the most feared consequences of operations for treatment of rectal cancer. Sharp dissection along the parietal pelvic fascia where the parasympathetic nerves are located significantly reduces the incidence of pelvic failure. Autonomic nerve—preserving pelvic sidewall dissections, which combined the benefits of en bloc parietal pelvic dissection with nerve preservation, were performed in 42 men who were undergoing sphincter-preserving operations for treatment of rectal cancer. Thirty-three (86.7%) of the 38 evaluable patients have remained potent, and 29 (87.9%) of the 33 patients have normal ejaculation. Deliberate sacrifice of the inferior hypogastric plexus caused only minor sexual dysfunction. Cancer recurred locally in only one patient (with stage D cancer). Autonomic nerve—preserving pelvic sidewall dissection combines the benefits of curative resection and local control with reduced morbidity, and it preserves potency.(Arch Surg. 1992;127:1396-1402)

Published
1992
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49. Total Mesorectal Excision – The New Golden Standard of Surgery for Rectal Cancer

Author

Enker, Warren E.

Abstract

Rectal cancer persists as a significant worldwide problem. Currently, surgery is associated with a poor prognosis, a high likelihood of permanent colostomy and a high rate of local recurrence in patients with regional disease (transmural penetration or involvement of regional mesenteric lymph nodes). Functional changes such as impotence and bladder dysfunction remain distressingly common consequences of conventional surgery. Over the past two decades, a fundamental change in operative technique has taken place. Conventional surgery (which is performed using blunt technique along undefinable tissue planes) has given way to sharp dissection along definable planes. The technique known as total mesorectal excision (TME) or complete circumferential mesorectal excision (CCME) produces the complete resection of an intact package of the rectum and its surrounding mesorectum, enveloped within the visceral pelvic fasia with uninvolved circumferential margins. As a result of TME, 5-year survival figures have risen from 45–50% to 75%, local recurrence rates have declined from 30% to 5–8%, sphincter preservation has risen by at least 20% for mid- and lower rectal cancers, and the rates of impotence and bladder dysfunction have declined from 50–85% to 15% or less. Patients with rectal cancer can now have a good prognosis, and intact image and high quality of life. The integration of multidisciplinary radiation therapy and chemotherapy into the care of patients undergoing TME or CCME for rectal cancer is presently under clinical trial.

Published
1997
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50. Posterior Transvertebral Osteotomy for Adult Thoracolumbar Kyphosis

Author

Lehmer, Steven M., Keppler, Louis, Biscup, Robert S., Enker, Paul, Miller, Scot D., and Steffee, Arthur D.

Abstract

A retrospective case study was performed on the single-stage posterior transvertebral closing-wedge osteotomy for treatment of adult thoracolumbar kyphosis.

Published
1994

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