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2. The birth of pediatric urology in the United States: From pioneers to subcertification.

Author

Caldamone, Anthony A., Cromie, William J., Patel, Sutchin R., Bloom, David A., Rushton, H. Gil, and Rabinowitz, Ronald

Abstract

Pediatric urology is a subspecialty of urology that emerged from a culture in which children with urological disorders were cared for by general urologists and general pediatric surgeons. The development of pediatric urology as a subspecialty was years in the making, highlighted by individuals who recognized that children with urological conditions were not just "small adults," but required special experience and training. Subspecialization was initiated by persistent visionaries who recognized the need for a trained cadre of experts to provide better care for children. It took the coordinated effort of all subgroups and leaderships in pediatric urology to push these efforts over the goal line. The focus of this review is to highlight certain individuals who played major roles in this vision and to document the efforts of many to coordinate the pathways to sub-specialization. The careers of Meredith F. Campbell and Frank B. Bicknell were researched to identify their rationale and roles in developing pediatric urology as a distinct medical specialty in the United States. In addition, the minutes of the meetings of the Pediatric Urology Advisory Council (PUAC) with the American Board of Urology (ABU) were reviewed. The origins of the Society for Pediatric Urology (SPU) and the American Academy of Pediatrics Section of Urology (AAP-SOU) were researched. The contributions of each to the certification of pediatric urology as a distinct subspecialty was delineated. Campbell was Chair of Urology at the New York University (NYU) School of Medicine and wrote prolifically about pediatric urology. He published one of the first practical textbooks in pediatric urology, almost completely self-written, in 1937. Bicknell, a general urologist in Michigan on the faculty at Wayne State University School of Medicine, led the initiative to create the Society for Pediatric Urology (SPU) that first met at the 1951 annual American Urological Association (AUA) meeting in Chicago and included nine attendees. Subsequently, John Lattimer (College of Physicians and Surgeons at Columbia University) organized a well-attended meeting of urologists interested in pediatrics at the 1964 annual AAP meeting in New York City. This led to the formation of the AAP Section on Urology. Integral to the justification for the development of a subspecialty was evidence of a published corpus of content. In addition to published textbooks devoted exclusively to pediatric urology, this was further fulfilled by the AAP Section on Urology Pediatric Supplement to the Journal of Urology , first published in 1986, and later with the Journal of Pediatric Urology in 2005. The SPU and the AAP Section on Urology came together to form the Pediatric Urology Advisory Council (PUAC) in 2000, which worked with the ABU to create subspecialty certification in pediatric urology with an independent exam, first administered in 2008 to 176 applicants. The metaphor "We have stood on the shoulders of giants" is apt for pediatric urology: Meredith Campbell, Frank Bicknell, David Innes Williams (Hospital for Sick Children, London), and J. Herbert Johnston (Alder Hay Hospital, Liverpool) come to mind among the first generation of pediatric urology pioneers, and others among their colleagues also had significant impact. Clearly this is a story of persistence and attention to detail on the part of those giants and those who followed. Pediatric urology became a distinct discipline after the SPU and AAP-SOU came together to create a robust cohort of pediatric urologists who through education and negotiation were able to help the ABU and the American Board of Medical Specialties (ABMS) recognize that subspecialization would lead to better care for children with urologic disorders. This benchmark set a high bar for future subspecialization in urology and other fields. [ABSTRACT FROM AUTHOR]

Published
2024
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12. Escherichia coli

Author

Rabinowitz, Ronald P., Donnenberg, Michael S., Bendinelli, Mauro, editor, Friedman, Herman, editor, and Paradise, Lois J., editor

Published
1996
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13. Mortality Risk Assessment in COVID-19 Venovenous Extracorporeal Membrane Oxygenation

Author

Tabatabai, Ali, primary, Ghneim, Mira H., additional, Kaczorowski, David J., additional, Shah, Aakash, additional, Dave, Sagar, additional, Haase, Daniel J., additional, Vesselinov, Roumen, additional, Deatrick, Kristopher B., additional, Rabin, Joseph, additional, Rabinowitz, Ronald P., additional, Galvagno, Samuel, additional, O’Connor, James V., additional, Menaker, Jay, additional, Herr, Daniel L., additional, Gammie, James S., additional, Scalea, Thomas M., additional, and Madathil, Ronson J., additional

Published
2021
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15. Breathing Life Back Into the Kidney—Continuous Renal Replacement Therapy and Veno-Venous Extracorporeal Membrane Oxygenation

Author

Deatrick, Kristopher B., primary, Mazzeffi, Michael A., additional, Galvagno, Samuel M., additional, Boswell, Kimberly, additional, Kaczoroswki, David J., additional, Rabinowitz, Ronald P., additional, Madathil, Ronson J., additional, Cornachione, Christopher R., additional, Herr, Daniel L., additional, Scalea, Thomas M., additional, and Menaker, Jay, additional

Published
2021
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22. CONTRIBUTORS

Author

Adkinson, N. Franklin, primary, Allen, David M., additional, Allos, Ban Mishu, additional, Amsden, Guy W., additional, Anderson, David A., additional, Andes, David R., additional, Aoki, Fred Y., additional, Apfalter, Petra M., additional, Apicella, Michael A., additional, Arias, Cesar A., additional, Augenbraun, Michael H., additional, Azar, Dimitri T., additional, Baddour, Larry M., additional, Baden, Lindsey R., additional, Baker, Carol J., additional, Ballard, Ronald C., additional, Ballow, Charles H., additional, Barnes, Scott D., additional, Baron, Miriam J., additional, Barouch, Dan H., additional, Barrett, Alan, additional, Bassin, Sarice L., additional, Batteiger, Byron E., additional, Baum, Stephen G., additional, Bayer, Arnold S., additional, Beckham, J. David, additional, Beekmann, Susan E., additional, Bell, Beth P., additional, Bennett, John E., additional, Berbari, Elie F., additional, Berman, Jonathan D., additional, Bertino, Joseph S., additional, Birdsall, Holly H., additional, Bisno, Alan L., additional, Biswas, Hope H., additional, Blackburn, Brian G., additional, Blaser, Martin J., additional, Blazes, David L., additional, Bleck, Thomas P., additional, Blijlevens, Nicole M.A., additional, Bobak, David A., additional, Bonnez, William, additional, Boothroyd, John C., additional, Borio, Luciana, additional, Bosque, Patrick J., additional, Boucher, Richard C., additional, Brause, Barry D., additional, Brown, Kevin E., additional, Brown, Patricia D., additional, Brown-Elliott, Barbara A., additional, Burd, Eileen M., additional, Burns, James E., additional, Bush, Larry M., additional, Calfee, David P., additional, Caplan, Ellis S., additional, Carael, Michel, additional, Carpenter, Charles C.J., additional, Caserta, Mary T., additional, Castagnola, Elio, additional, Chaisson, Richard E., additional, Chambers, Henry F., additional, Chapman, Stanley W., additional, Chappell, James D., additional, Chen, Sharon C-A., additional, Chopra, Sanjiv, additional, Chow, Anthony W., additional, Chroneou, Alexandra, additional, Cianciotto, Nicholas P., additional, Clark, Rebecca A., additional, Clark, Robert A., additional, Cohen, Jeffrey I., additional, Cohen, Myron S., additional, Cohen-Poradosu, Ronit, additional, Cohn, Susan E., additional, Connors, Mark, additional, Cono, Joanne, additional, Corey, Lawrence, additional, Cornett, Patricia A., additional, Cox, Heather L., additional, Craig, William A., additional, Craven, Donald E., additional, Crossley, Kent B., additional, Crump, John A., additional, Crumpacker, Clyde S., additional, Curran, James W., additional, Currie, Bart J., additional, Curry, Michael P., additional, Damon, Inger K., additional, Darouiche, Rabih O., additional, DeBiasi, Roberta L., additional, Deepe, George S., additional, del Rio, Carlos, additional, DeMuri, Gregory P., additional, Dennis, David T., additional, Densen, Peter, additional, De Pauw, Ben E., additional, Dermody, Terence S., additional, Dewar, Robin, additional, Diaz, James H., additional, Dieffenbach, Carl W., additional, Dienstag, Jules L., additional, Dolin, Raphael, additional, Donaldson, Scott H., additional, Donnelly, J. Peter, additional, Donnenberg, Michael S., additional, Donowitz, Gerald R., additional, Dormitzer, Philip R., additional, Drake, James M., additional, Dumler, J. Stephen, additional, Dummer, J. Stephen, additional, DuPont, Herbert L., additional, Durack, David T., additional, Durand, Marlene L., additional, Edelstein, Paul H., additional, Edmond, Michael B., additional, Edwards, John E., additional, Edwards, Morven S., additional, Eliopoulos, George M., additional, Engleberg, N. Cary, additional, Ernst, Joel D., additional, Fairhurst, Rick M., additional, Fairley, Jessica K., additional, Falkow, Stanley, additional, Falsey, Ann R., additional, Fauci, Anthony S., additional, Feinstone, Stephen M., additional, Fekete, Thomas, additional, Fey, Paul D., additional, Fine, Steven M., additional, Finegold, Sydney M., additional, Fishman, Neil O., additional, Fitzgerald, Daniel W., additional, Flores, Anthony R., additional, Fowler, Vance G., additional, Freedman, David O., additional, Friedlander, Arthur M., additional, Galgiani, John N., additional, Gallin, John I., additional, Gallo, Robert C., additional, Garrett, Wendy S., additional, Gelfand, Jeffrey A., additional, Gelone, Steven P., additional, Gershon, Anne A., additional, Gilbert, David N., additional, Gilligan, Peter H., additional, Glickman, Michael S., additional, Göbel, Ulf B., additional, Goldstein, Deborah, additional, Goldstein, Ellie J.C., additional, Gordin, Fred M., additional, Gotuzzo, Eduardo, additional, Graman, Paul S., additional, Graves, Margot, additional, Griffin, Patricia M., additional, Griffith, David E., additional, Guerrant, Richard L., additional, Haake, David A., additional, Haas, David W., additional, Hall, Caroline Breese, additional, Halperin, Scott, additional, Hammerschlag, Margaret R., additional, Handsfield, H. Hunter, additional, Haque, Rashidul, additional, Hartman, Barry J., additional, Hay, Roderick J., additional, Hayden, Frederick G., additional, Hedberg, Craig W., additional, Henderson, David K., additional, Henderson, Donald A., additional, Hendley, J. Owen, additional, Hewlett, Erik L., additional, High, Kevin P., additional, Hill, Adrian V.S., additional, Hill, David R., additional, Hinman, Alan R., additional, Hirsch, Martin S., additional, Hodges, Lisa S., additional, Holland, Steven M., additional, Hook, Edward W., additional, Hooper, David C., additional, Hooton, Thomas M., additional, Horsburgh, C. Robert, additional, Hospenthal, Duane R., additional, Hughes, James M., additional, Hughes, Molly A., additional, Huston, Christopher D., additional, Hynes, Noreen A., additional, Iredell, Jonathan R., additional, Janda, J. Michael, additional, Johannsen, Eric C., additional, Johnson, Warren D., additional, Kashuba, Angela D.M., additional, Kasper, Dennis L., additional, Kaye, Donald, additional, Kaye, Keith S., additional, Kaye, Kenneth M., additional, Kazura, James W., additional, Kenny, George E., additional, Keystone, Jay S., additional, Khabbaz, Rima F., additional, King, Charles H., additional, Kirchhoff, Louis V., additional, Klein, Jerome O., additional, Knoll, Bettina M., additional, Knowlton, Kirk U., additional, Kohlhoff, Stephan A., additional, Könönen, Eija, additional, Kontoyiannis, Dimitrios P., additional, Koralnik, Igor J., additional, Koshy, Anita A., additional, Kotton, Camille Nelson, additional, Kovacs, Joseph A., additional, Kozarsky, Phyllis, additional, Koziel, Margaret James, additional, Krieger, John N., additional, Kuehnert, Matthew J., additional, LeDuc, James W., additional, Lee, Laura M., additional, Leggett, James E., additional, Lescano, Andres G., additional, Levett, Paul N., additional, Levine, Donald P., additional, Levison, Matthew E., additional, Lewis, Russell E., additional, Liles, W. Conrad, additional, Lima, Aldo A.M., additional, Litman, Nathan, additional, Lorber, Bennett, additional, Lutwick, Larry I., additional, MacGregor, Rob Roy, additional, Mackowiak, Philip A., additional, Madoff, Lawrence C., additional, Magill, Alan J., additional, Maguire, James H., additional, Maldarelli, Frank, additional, Mandell, Lionel A., additional, Mann, Barbara J., additional, Markoff, Lewis, additional, Marrazzo, Jeanne M., additional, Marrie, Thomas J., additional, Marth, Thomas, additional, Martin, Gregory J., additional, Maschmeyer, Georg, additional, Masur, Henry, additional, Mawle, Alison, additional, Mayer, Kenneth H., additional, McBride, John T., additional, McCormack, William M., additional, McIntosh, Kenneth, additional, Mead, Paul S., additional, Meyer, Daniel K., additional, Meyers, Burt R., additional, Miller, Mark A., additional, Miller, Samuel I., additional, Mitchell, David H., additional, Modlin, John F., additional, Moellering, Robert C., additional, Moir, Susan, additional, Montgomery, Joel M., additional, Montoya, José G., additional, Moore, Thomas A., additional, Moreillon, Philippe, additional, Morrell, Dean S., additional, Morris, J. Glenn, additional, Morse, Caryn Gee, additional, Moseley, Robin, additional, Muder, Robert R., additional, Munford, Robert S., additional, Murphy, Edward L., additional, Murphy, Timothy F., additional, Murray, Barbara E., additional, Murray, Clinton K., additional, Murray, Patrick R., additional, Musher, Daniel M., additional, Nannini, Esteban C., additional, Nash, Theodore E., additional, Nauseef, William M., additional, Neill, Marguerite A., additional, O'Donnell, Judith A., additional, Ohl, Christopher A., additional, Okhuysen, Pablo C., additional, Onderdonk, Andrew B., additional, Opal, Steven M., additional, Orenstein, Walter A., additional, Osman, Douglas R., additional, Osterholm, Michael T., additional, Ostroff, Stephen M., additional, Oxman, Michael N., additional, Page, Andrea V., additional, Palmore, Tara N., additional, Pamer, Eric G., additional, Pappas, Peter G., additional, Pasternack, Mark S., additional, Patterson, Thomas F., additional, Pavan-Langston, Deborah, additional, Pegues, David A., additional, Penn, Robert L., additional, Perfect, John R., additional, Perlman, Stanley, additional, Peters, C.J., additional, Peterson, Phillip K., additional, Petri, William A., additional, Petti, Cathy A., additional, Pickering, Larry K., additional, Pier, Gerald B., additional, Pillai, Satish K., additional, Piot, Peter, additional, Plaeger, Susan F., additional, Polk, Ronald E., additional, Pop-Vicas, Aurora, additional, Powers, John H., additional, Punturieri, Antonello, additional, Que, Yok-ai, additional, Rabinowitz, Ronald P., additional, Rabizadeh, Shervin, additional, Ramphal, Reuben, additional, Raoult, Didier, additional, Ravdin, Jonathan I., additional, Ray, Stuart C., additional, Reboli, Annette C., additional, Reddy, Pavani, additional, Reichman, Richard C., additional, Reitz, Marvin S., additional, Relman, David A., additional, Renault, Cybèle A., additional, Restrepo, Angela, additional, Rex, John H., additional, Reynolds, Herbert Y., additional, Rhee, Elizabeth G., additional, Rhee, Kyu Y., additional, Rotz, Lisa D., additional, Ruoff, Kathryn L., additional, Rupp, Mark E., additional, Rupprecht, Charles E., additional, Russo, Thomas A., additional, Rutala, William A., additional, Salvatore, Mirella, additional, Saulsbury, Frank T., additional, Savoia, Maria C., additional, Sax, Paul E., additional, Scheld, W. Michael, additional, Schiffer, Joshua T., additional, Schlossberg, David, additional, Schneider, Thomas, additional, Schwebke, Jane R., additional, Sears, Cynthia L., additional, Seas, Carlos, additional, Sepkowitz, Kent A., additional, Septimus, Edward J., additional, Siberry, George K., additional, Sifri, Costi D., additional, Singh, Nina, additional, Singh, Upinder, additional, Sinner, Scott W., additional, Sivapalasingam, Sumathi, additional, Slater, Leonard N., additional, Smulian, A. George, additional, Sobel, Jack D., additional, Sodha, Samir V., additional, Sohail, M. Rizwan, additional, Solomon, Tom, additional, Song, Yuli, additional, Soper, David E., additional, Sorrell, Tania C., additional, Sparling, P. Frederick, additional, Stamm, Walter E., additional, Steckelberg, James M., additional, Steere, Allen C., additional, Steigbigel, Neal H., additional, Steinberg, James P., additional, Steiner, Theodore S., additional, Sterling, Timothy R., additional, Stevens, David A., additional, Stevens, Dennis L., additional, Strahilevitz, Jacob, additional, Stratton, Charles W., additional, Suffredini, Anthony F., additional, Suh, Kathryn N., additional, Sulkowski, Mark S., additional, Sullivan, Donna C., additional, Swartz, Morton N., additional, Talbot, Thomas R., additional, Tan, C. Sabrina, additional, Thielman, Nathan M., additional, Thio, Chloe Lynn, additional, Thomas, David L., additional, Thomas, Lora D., additional, Thorner, Anna R., additional, Tice, Alan D., additional, Tobón, Angela María, additional, Tramont, Edmund C., additional, Treanor, John J., additional, N. Tsibris, Athe M., additional, Tunkel, Allan R., additional, Turner, Ronald B., additional, Tyler, Kenneth L., additional, van de Beek, Diederik, additional, Vannier, Edouard G., additional, Van Schooneveld, Trevor C., additional, Vaughn, David W., additional, Viscoli, Claudio, additional, Volberding, Paul A., additional, Wald, Ellen R., additional, Walker, David H., additional, Wallace, Richard J., additional, Walsh, Edward E., additional, Walzer, Peter D., additional, Wanke, Christine A., additional, Washburn, Ronald G., additional, Wasley, Annemarie, additional, Waters, Valerie, additional, Weber, David J., additional, Weinberg, Arnold N., additional, Weinberg, Geoffrey A., additional, Weinmann, Gail G., additional, Weisdorf, Daniel J., additional, Weiss, Louis M., additional, Weiss, Michael E., additional, Welch, David F., additional, Wellems, Thomas E., additional, Wenzel, Richard P., additional, Wharton, Melinda, additional, White, A. Clinton, additional, Whitley, Richard J., additional, Wilson, Kenneth H., additional, Wilson, Walter R., additional, Witebsky, Frank G., additional, Wolfgang, Matthew C., additional, Wright, Peter F., additional, Young, Edward J., additional, Young, Jo-Anne H., additional, Zhang, Jie Lin, additional, Zinner, Stephen H., additional, and Zurlo, John J., additional

Published
2010
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24. Intoxication and overdose should not preclude veno-venous extracorporeal membrane oxygenation

Author

Radowsky, Jason S, primary, Mazzeffi, Michael M, additional, Deatrick, K Barry, additional, Galvagno, Samuel M, additional, Parker, Brandon M, additional, Tabatabai, Ali, additional, Madathil, Ronson J, additional, Kaczorowski, David J, additional, Rabinowitz, Ronald P, additional, Herr, Daniel L, additional, Scalea, Thomas, additional, and Menaker, Jay, additional

Published
2020
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26. Intoxication and overdose should not preclude veno-venous extracorporeal membrane oxygenation.

Author

Radowsky, Jason S, Mazzeffi, Michael M, Deatrick, K Barry, Galvagno, Samuel M, Parker, Brandon M, Tabatabai, Ali, Madathil, Ronson J, Kaczorowski, David J, Rabinowitz, Ronald P, Herr, Daniel L, Scalea, Thomas, and Menaker, Jay

Subjects
EVALUATION of medical care, MATHEMATICAL statistics, NONPARAMETRIC statistics, SURVIVAL, LENGTH of stay in hospitals, RESPIRATORY insufficiency, ACQUISITION of data methodology, PARAMETERS (Statistics), HYDROGEN-ion concentration, DRUG overdose, AGE distribution, EXTRACORPOREAL membrane oxygenation, ALCOHOLIC intoxication, RETROSPECTIVE studies, FISHER exact test, MEDICAL records, LACTATES, DESCRIPTIVE statistics, CHI-squared test, DRUGS of abuse, BODY mass index, DATA analysis software, LONGITUDINAL method, EVALUATION
Abstract

Introduction: Acute intoxication (AI) related morbidity and mortality are increasing in the United States. For patients with severe respiratory failure in the setting of an acute ingestion, veno-venous extracorporeal membrane oxygenation (VV ECMO) can provide salvage therapy. The purpose of this study was to evaluate outcomes in patients with overdose-related need for VV ECMO. Methods: We performed a retrospective review of all patients admitted to a specialty VV ECMO unit between August 2014 and August 2018. Patients were stratified by those whose indication for VV ECMO was directly related to an acute ingestion (alcohol, illicit drug, or prescription drug overdose) and those with unrelated diagnoses. Demographics, pre-cannulation clinical characteristics, ECMO parameters, and outcomes data was collected and analyzed with parametric and non-parametric statistics as indicated. Results: 189 patients were enrolled with 27 (14%) diagnosed with AI. Patients requiring VV ECMO for an AI were younger, had lower median BMI and PaO2/FiO2, and higher RESP scores than non-AI patients (p = 0.002, 0.01, 0.03 and 0.01). There was no difference in pre-cannulation pH, lactate, or SOFA scores between the two groups (p = 0.24, 0.5, 0.6). There was no difference in survival to discharge (p = 0.95). Among survivors, there was no difference in ECMO time or hospital stay (p = 0.24, 0.07). Conclusion: We demonstrate no survival difference for patients with and without an AI-related need for VV ECMO. AI patients should be supported with VV ECMO when traditional therapies fail despite potential stigma against acceptance on referral. [ABSTRACT FROM AUTHOR]

Published
2021
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31. Pilot study evaluating a non-titrating, weight-based anticoagulation scheme for patients on veno-venous extracorporeal membrane oxygenation

Author

Deatrick, Kristopher B, primary, Galvagno, Samuel M, additional, Mazzeffi, Michael A, additional, Kaczoroswki, David J, additional, Herr, Daniel L, additional, Rector, Raymond, additional, Hochberg, Eric, additional, Rabinowitz, Ronald P, additional, Scalea, Thomas M, additional, and Menaker, Jay, additional

Published
2019
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33. Pilot study evaluating a non-titrating, weight-based anticoagulation scheme for patients on veno-venous extracorporeal membrane oxygenation.

Author

Deatrick, Kristopher B, Galvagno, Samuel M, Mazzeffi, Michael A, Kaczoroswki, David J, Herr, Daniel L, Rector, Raymond, Hochberg, Eric, Rabinowitz, Ronald P, Scalea, Thomas M, and Menaker, Jay

Subjects
THROMBOSIS prevention, ALGORITHMS, CHI-squared test, EXTRACORPOREAL membrane oxygenation, FISHER exact test, HEPARIN, LONGITUDINAL method, RESEARCH funding, STATISTICAL sampling, VOLUMETRIC analysis, PILOT projects, RANDOMIZED controlled trials, TREATMENT effectiveness, DESCRIPTIVE statistics, PHARMACODYNAMICS
Abstract

Objective: There is no universally accepted algorithm for anticoagulation in patients on veno-venous extracorporeal membrane oxygenation. The purpose of this pilot study was to compare a non-titrating weight-based heparin infusion to that of a standard titration algorithm. Methods: We performed a prospective randomized non-blinded study of patients: Arm 1—standard practice of titrating heparin to activated partial thromboplastin times goal of 45-55 seconds, and Arm 2—a non-titrating weight-based (10 units/kg/h) infusion. Primary outcome was need for oxygenator/circuit changes. Secondary outcomes included differences in hemolysis and bleeding episodes. Descriptive statistics were performed for the continuous data, and primary and secondary outcomes were compared using Fisher's exact test as appropriate. Results: Six patients were randomized to Arm 1 and four to Arm 2. There was no difference in age, pH, PaO2/FiO2 ratio, peak inspiratory pressure, positive end expiratory pressure, mean airway pressure at time of cannulation, time on extracorporeal membrane oxygenation, or survival to hospital discharge in the two arms. Arm 1 had a statistically higher median activated partial thromboplastin times (48 (43, 52) vs 38 (35, 42), p < 0.008) and lower LDH (808 units/L (727, 1112) vs 940 units/L (809, 1137), p = 0.02) than Arm 2. There was no difference in plasma hemoglobin (4.3 (2.5, 8.7) vs 4.3 (3.0, 7.3), p = 0.65) between the two arms. There was no difference in mean oxygenator/circuit change, transfused packed red blood cell, or documented bleeding complications per patient in each arm (p = 0.56, 0.43, 0.77, respectively). Conclusion: In this pilot study, a non-titrating, weight-based heparin infusion appears safe and as effective in preventing veno-venous extracorporeal membrane oxygenation circuit thrombotic complications as compared to a titration algorithm. Larger studies are needed to confirm these preliminary findings. [ABSTRACT FROM AUTHOR]

Published
2020
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35. Epidemiology of blood stream infection in adult extracorporeal membrane oxygenation patients: A cohort study.

Author

Menaker, Jay, Galvagno, Samuel, Rabinowitz, Ronald, Penchev, Vesselin, Hollis, Allison, Kon, Zachary, Deatrick, Kristopher, Amoroso, Anthony, Herr, Daniel, and Mazzeffi, Michael

Abstract

The purpose of our study was to characterize the epidemiology of blood stream infection (BSI) in adult extracorporeal membrane oxygenation (ECMO) patients at a single tertiary care academic medical center with standardized post-cannulation antibiotic prophylaxis practices. A single-center retrospective cohort study was performed over a five-year period. BSI incidence was characterized and patients who developed BSI during ECMO were compared with those who did not. Nineteen of 145 VV ECMO patients (13.1%) developed BSI while 7 of 123 VA ECMO patients (5.7%) developed BSI. When accounting for total ECMO days, the incidence rate was 8 BSIs per 1,000 ECMO days for both VV and VA ECMO patients. VV ECMO patients with BSI had longer ECMO runs and more red blood cell transfusion (both p<0.05). VA ECMO patients who developed BSI had longer ECMO runs and more platelet transfusion (both p<0.05). In VV ECMO patients there was an association between renal failure and BSI and in VA ECMO patients there was an association between hepatic failure and BSI. BSIs are common in ECMO patients even with post-cannulation antimicrobial prophylaxis and are associated with ECMO duration, blood transfusion, and organ failure. Further work is needed to clarify the optimal duration and type of antimicrobial prophylaxis, as well as surveillance strategies for BSIs during adult ECMO. [ABSTRACT FROM AUTHOR]

Published
2019
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38. Annie, Annie! Are You Okay?: Faces Behind the Resusci Anne Cardiopulmonary Resuscitation Simulator

Author

Gordetsky, Jennifer B., Rais-Bahrami, Soroush, and Rabinowitz, Ronald

Abstract

We investigated the history of Resusci Anne, the well-known cardiopulmonary resuscitation (CPR) simulation trainer. The creation of Resusci Anne began with Peter J. Safar, an accomplished anesthesiologist who experimented with resuscitation of respiration and cardiac function. He collaborated with Asmund S. Laerdal, whose early experimentation with soft plastics allowed him to create a human simulator that could be used to teach the skills of resuscitation to both medical care practitioners and individuals of all walks of life. A special face was chosen for the simulation mannequin, one based on a mysterious death mask of a beautiful woman from the late 19th century. The success of Resusci Anne led to the widespread acceptance of CPR and simulation use in medical training.

Published
2020
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41. Third trimester ultrasound of fetal pyelectasis: Predictor for postnatal surgery.

Author

Thornburg, Loralei L., Pressman, Eva K., Chelamkuri, Satya, Hulbert, William, Rabinowitz, Ronald, and Mevorach, Robert

Subjects
THIRD trimester of pregnancy, RESONANT ultrasound spectroscopy, INFANTS, SURGERY, HYDRONEPHROSIS in children
Abstract

Abstract: Objective: The ability to predict surgically relevant fetal renal pyelectasis is limited. We sought to determine whether the intrauterine timing of prenatal pyelectasis can predict the need for postnatal surgery. Methods: We retrospectively reviewed all patients with ultrasound measurements of the fetal renal pelvis during the 2nd and 3rd trimesters and postnatally. Pyelectasis was defined as >7mm for renal pelvis antero-posterior diameter in the 2nd trimester and >10mm in the 3rd trimester. Results: Fifty-nine patients out of 2397 candidates met the criteria for inclusion. A total of 116 kidneys were analyzed independently. Second trimester pyelectasis was associated with grade of postnatal hydronephrosis but not the need for surgery. Third trimester pyelectasis was associated with both postnatal hydronephrosis and surgery. The positive and negative predictive values for postnatal surgery were respectively 18% and 95% in the second trimester, and 27% and 100% in the third trimester. Conclusions: Third trimester ultrasound for fetal pyelectasis was better able to predict surgically relevant hydronephrosis than second trimester ultrasound. [Copyright &y& Elsevier]

Published
2008
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42. Results of a 2-Year Multicenter Trial of Endoscopic Treatment of Vesicoureteral Reflux With Synthetic Calcium Hydroxyapatite.

Author

Mevorach, Robert A., Hulbert, William C., Rabinowitz, Ronald, Kennedy, William A., Kogan, Barry A., Kryger, John V., Caldamone, Anthony, Clark, William R., Kaplan, George W., Durkee, Charles T., and Elder, Jack S.

Subjects
VESICO-ureteral reflux, PREOPERATIVE care, PEDIATRIC urology, RESEARCH methodology, ENDOUROLOGY
Abstract

Purpose: With no FDA approved material available for endoscopic treatment of vesicoureteral reflux, in 2001 we began a prospective multicenter trial of synthetic calcium hydroxyapatite as a subureteral bulking agent in children with traditional indications for surgical repair. Materials and Methods: A total of 98 patients (155 ureters) with grades II to IV reflux were enrolled at 10 sites in the United States to obtain 86 patients with completed protocol end points at 3 months. Of the 86 patients 74 underwent renal and bladder ultrasonography, blood count and serum chemistry analysis, and VCUG at 1 year. A total of 46 patients (47%) completed 2-year study end points, including VCUG. Results: At 1 and 2 years 24 of the 74 patients (32%) were cured. Ureteral cure rates were 46% and 40% at 1 and 2 years, respectively. With 35 patients treated and 85% compliance with the required 2-year VCUG the primary center achieved 2-year cure rates of 66% of patients and 72% of ureters. Conclusions: Synthetic calcium hydroxyapatite is a safe, durable and effective material for endoscopic treatment of VUR. Increased experience with the injection of synthetic calcium hydroxyapatite yields improved results. [Copyright &y& Elsevier]

Published
2006
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44. Incomplete Lemierre Syndrome

Author

Shiber, Joseph, Fontane, Emily, Rabinowitz, Ronald, Gens, David, Habashi, Nader, and Scalea, Thomas

Abstract

An invasive Fusobacteriuminfection may originate from an apparent routine pharyngitis and lead to significant distant septic complications. Even without internal jugular thrombosis, the same mechanism of disease exists, and therefore, the same morbidity, prognosis, and treatments are applicable, hence the suitable term incomplete Lemierre syndrome. We present a case of invasive Fusobacteriuminfection that meets all criteria for Lemierre syndrome except lacking internal jugular thrombosis. A review of the literature that forms the diagnostic criteria for this syndrome and the rationale for our creating this novel term is presented.

Published
2015
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45. Testicular Abscess: Diagnosis by Ultrasonography

Author

Mevorach, Robert A., Lerner, Robert M., Dvoretsky, Phillip M., and Rabinowitz, Ronald

Abstract

We reviewed 8 cases of surgically proved testicular abscess with emphasis upon the ultrasonographic findings. The images were correlated with testicular anatomy and the pathological findings of abscess formation. In 3 of 8 patients undergoing serial high resolution ultrasound examinations a consistent pattern of testicular abscess was present 1 to 7 weeks preoperatively. In the remaining 5 patients preoperative ultrasound documented the presence of abscess. Recognition of the ultrasonographic appearance of testicular abscess should permit expedient surgical intervention.

Published
1986
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47. Surgical Treatment of the Massively Dilated Ureter in Children. Part I. Management by Cutaneous Ureterostomy

Author

Rabinowitz, Ronald, Barkin, Martin, Schillinger, John F., Jeffs, Robert D., and Cook, Gerald T.

Abstract

One of the major therapeutic challenges facing the pediatric urologist is the massively dilated ureter. When conservative measures, such as relief of obstruction or treatment of infection, have failed or are likely to fail, surgical treatment must be directed at the massive dilatation itself. These circumstances were encountered in 366 massively dilated ureters in 244 children during a 10-year period. Loop and/or terminal cutaneous ureterostomy was used to manage 125 of these ureters in 74 children. Indications for temporary non-intubated proximal urinary diversion included uncontrolled infection, sepsis, azotemia, significant ureteral redundancy and tortuosity, and questionable over-all renal function. Advantages of loop ureterostomy included more proximal drainage and less stomal problems but terminal ureterostomy required a significantly lesser number of surgical procedures in reconstructing the urinary tract. Temporary splinting of the ureter in dry ureteral reimplantations has diminished markedly the incidence of ureterovesical complications. No instances of permanent vesical contracture were noted after long periods of defunctionalization. After initial reconstruction of 47 cutaneous ureterostomies good results by all parameters were obtained in 68 per cent. Additional surgical procedures in selected initial failures have resulted in a final success rate of 85 per cent.

Published
1977
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48. Vesicorectostomy Revisited

Author

Rabinowitz, Ronald, O’donnell, Walter F., King, Leo M., and Moore, Joseph G.

Abstract

Between 1948 and 1959 vesicorectostomy, a permanent anastomosis between the bladder and rectum, was constructed in 7 male patients. Scattered reports of this procedure exist but none since 1959 and long-term followup has never been reported. We present long-term followup, including renal function, excretory urography and voiding cystorectography, and review the quality of life in the 7 patients. The most frequent complication was stenosis of the anastomosis. None of the patients in this series with normal preoperative upper tracts showed radiographic or chemical deterioration postoperatively. Since this procedure maintains urinary continence, does not disturb the normal physiology of the ureterovesical junction and minimizes urinary reabsorption its use should be considered in certain patients as an alternative method of urinary diversion.

Published
1976
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49. Nuclear Imaging in the Pediatric Acute Scrotum

Author

Valvo, John R., Caldamone, Anthony A., O'Mara, Robert, and Rabinowitz, Ronald

Abstract

• The acute scrotum in the pediatric patient frequently presents a diagnostic dilemma for even the most experienced clinician. In an effort to improve testicular salvage in equivocal cases, immediate surgical intervention has been recommended, despite a large number of unnecessary explorations. Evaluating the sodium pertechnetate Tc 99m radioisotopic scan in 46 boys, we found this study to be a rapid, reliable, sensitive, and noninvasive test that allows the selection of those patients who require immediate surgical intervention.(Am J Dis Child 1982;136:831-835)

Published
1982
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50. Surgical Treatment of the Massively Dilated Ureter in Children. Part II. Management by Primary Reconstruction

Author

Rabinowitz, Ronald, Barkin, Martin, Schillinger, John F., Jeffs, Robert D., and Cook, Gerald T.

Abstract

Treatment of the massively dilated ureter is one of the major therapeutic challenges facing the pediatric urologist. When conservative measures, such as treatment of infection or relief of obstruction, fail or are likely to fail surgical treatment must be directed at the ureteral dilatation itself. These circumstances were encountered in 244 children with 366 massively dilated ureters during a 10-year period. In evaluating the surgical management of the massively dilated ureter in children a retrospective analysis of primary ureteral tailoring and/or preliminary nephrostomy and subsequent reconstruction in 131 children with 171 massively dilated ureters was done. In these instances sepsis, azotemia, and ureteral tortuosity and redundancy were not significant enough to indicate long-term non-intubated diversion. Transvesical and extravesical tailoring procedures were evaluated. Of those in whom preliminary nephrostomy was applied ureteral dilatation decreased to such an extent that non-tailored reimplantation was performed in more than 25 per cent. Initial upper tract tailoring, although not recommended by others, was done with uniform success. Subsequent upper tract tailoring was required in only 3 per cent of those who initially underwent lower ureteral reconstruction. The over-all success rate of these primary reconstructive procedures was 87 per cent by all parameters. Additional surgical procedures in selected initial failures have resulted in a final success rate of 90 per cent. Of those unsuccessful reconstructions a significant number were secondary to acquired hypotonic bladder after extensive perivesical dissection in patients who had undergone multiple suprapubic procedures. It is for this reason that, when applicable, the transvesical approach was preferred.

Published
1977
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