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  1. Article ; Online: An obstetrician-gynecologist's review of hernias: risk factors, diagnosis, prevention, and repair.

    Knochenhauer, Hope E / Lim, Stephanie L / Brown, David A / Darner, Grant / Levinson, Howard / Havrilesky, Laura J / Previs, Rebecca A

    American journal of obstetrics and gynecology

    2023  Volume 229, Issue 3, Page(s) 214–221

    Abstract: Management of obstetrical and gynecologic patients with hernias poses challenges to providers. Risks for hernia development include well-described factors that impair surgical wound healing and increase abdominal pressure. Among the diverse populations ... ...

    Abstract Management of obstetrical and gynecologic patients with hernias poses challenges to providers. Risks for hernia development include well-described factors that impair surgical wound healing and increase abdominal pressure. Among the diverse populations cared for by obstetricians and gynecologists, pregnant patients and those with gynecologic malignancies are at the highest risk for hernia formation. This article provides an overview of the existing literature, with a focus on patients cared for by obstetrician-gynecologists and commonly encountered preoperative and intraoperative scenarios. We highlight scenarios when a hernia repair is not commonly performed, including those of patients undergoing nonelective surgeries with known or suspected gynecologic cancers. Finally, we offer multidisciplinary recommendations on the timing of elective hernia repair with obstetrical and gynecologic procedures, with attention to the primary surgical procedure, the type of preexisting hernia, and patient characteristics.
    MeSH term(s) Pregnancy ; Humans ; Female ; Hernia, Ventral/etiology ; Hernia, Ventral/surgery ; Obstetricians ; Gynecologists ; Surgical Mesh ; Neoplasm Recurrence, Local/etiology ; Risk Factors ; Herniorrhaphy/adverse effects ; Herniorrhaphy/methods
    Language English
    Publishing date 2023-04-27
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 80016-8
    ISSN 1097-6868 ; 0002-9378
    ISSN (online) 1097-6868
    ISSN 0002-9378
    DOI 10.1016/j.ajog.2023.04.024
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Symptom Duration and Diabetic Control Influence Success of Steroid Injection in Trigger Finger.

    Hollins, Andrew W / Hein, Rachel / Atia, Andrew / Taskindoust, Mahsa / Darner, Grant / Shammas, Ronnie / Mithani, Suhail K

    Plastic and reconstructive surgery

    2022  Volume 150, Issue 2, Page(s) 357e–363e

    Abstract: Background: Trigger finger is one of the most common hand abnormalities, with a prevalence of 2 percent of the general population. Conservative treatment with corticosteroid injections at the A1 pulley has been shown to be a cost-effective first-line ... ...

    Abstract Background: Trigger finger is one of the most common hand abnormalities, with a prevalence of 2 percent of the general population. Conservative treatment with corticosteroid injections at the A1 pulley has been shown to be a cost-effective first-line treatment. However, additional patient factors have not fully been described regarding steroid injection efficacy. The authors hypothesize that patients presenting with longer chronicity of symptoms before treatment and elevated blood glucose would have reduced success rates of steroid injection therapy.
    Methods: A retrospective chart review of 297 patients at a single institution was performed between 2013 and 2019. Patients were included if they presented with the diagnosis of trigger finger and were treated with initial corticosteroid injection at the A1 pulley.
    Results: Steroid injection therapy alone was successful in 65 percent of patients. Patients received on average of 1.61 steroid injections. Patients who failed treatment received an average of 1.85 injections compared to 1.49 for those who had successful corticosteroid injection therapy ( p = 0.001). Presence of ipsilateral hand disease was associated with significant increase in failure of steroid injections (43.4 percent versus 30.8 percent; p = 0.032). Diabetic patients with hemoglobin A1c levels greater than 6.5 percent had a significantly higher rate of failing steroid injection therapy (71.9 percent versus 38.1 percent; p < 0.001). Patients who presented with greater than 2.5 months of symptoms had a higher failure rate of corticosteroid therapy (40.4 percent versus 29.5 percent; p = 0.048).
    Conclusion: Patients with a coexisting diagnosis of diabetes and a hemoglobin A1c level greater than 6.5 percent, ipsilateral concomitant hand disease, or presence of symptoms for greater than 2.5 months should be counseled regarding higher risk of failure of local corticosteroid injection.
    Clinical question/level of evidence: Risk, III.
    MeSH term(s) Adrenal Cortex Hormones/therapeutic use ; Diabetes Mellitus ; Glycated Hemoglobin A ; Humans ; Retrospective Studies ; Steroids ; Treatment Outcome ; Trigger Finger Disorder/drug therapy
    Chemical Substances Adrenal Cortex Hormones ; Glycated Hemoglobin A ; Steroids
    Language English
    Publishing date 2022-06-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 208012-6
    ISSN 1529-4242 ; 0032-1052 ; 0096-8501
    ISSN (online) 1529-4242
    ISSN 0032-1052 ; 0096-8501
    DOI 10.1097/PRS.0000000000009320
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Variations in Incidence of Trigger Finger and Response to Corticosteroid Injection after Aromatase Inhibitor Therapy for Breast Cancer.

    Hollins, Andrew W / Hein, Rachel E / Atia, Andrew N / Zhang, Gloria X / Sergesketter, Amanda R / Darner, Grant / Morris, Miranda / Mithani, Suhail K

    Plastic and reconstructive surgery

    2022  Volume 151, Issue 5, Page(s) 1043–1050

    Abstract: Background: Aromatase inhibitors (AIs), such as letrozole and anastrozole, have been demonstrated to have significant musculoskeletal symptoms in patients. The purpose of this study was to evaluate the effect of specific AI medications on the incidence ... ...

    Abstract Background: Aromatase inhibitors (AIs), such as letrozole and anastrozole, have been demonstrated to have significant musculoskeletal symptoms in patients. The purpose of this study was to evaluate the effect of specific AI medications on the incidence of trigger finger and independent factors affecting treatment outcomes within this population.
    Methods: A retrospective chart review was performed at the authors' institution between the years 2014 and 2018 in patients with the diagnosis of breast cancer. This cohort was then sorted based on receiving medication regimens, trigger finger diagnosis, steroid injections, and need for surgical release of trigger finger.
    Results: A total of 15,144 patients were included for initial review. The overall rate of trigger finger diagnosis was 2.75% in the entire breast cancer population and 4.5% for patients receiving AI therapy. Patients taking letrozole and anastrozole had an increased odds ratio of 2.0 and 1.7, respectively, for developing trigger finger. Patients who switched between letrozole and anastrozole during treatment had a higher rate of failed steroid injection treatment (45.2% versus 23.5%; P = 0.021). Among patients receiving AI treatment diagnosed with trigger finger, diabetes and hemoglobin A1c level greater than 6.5 were associated with significantly increased rates of failed steroid therapy.
    Conclusions: Patients receiving AI therapy have an increased incidence of trigger finger. The outcomes of treatment are equivalent between AI and non-AI trigger finger populations. However, steroid therapy is more likely to fail in patients who require switching of regimens because of significant musculoskeletal symptoms. Poorly controlled diabetes was also an independent factor for compromised steroid treatment of trigger finger.
    Clinical question/level of evidence: Therapeutic, III.
    MeSH term(s) Humans ; Female ; Aromatase Inhibitors/adverse effects ; Breast Neoplasms/drug therapy ; Breast Neoplasms/surgery ; Anastrozole/adverse effects ; Letrozole/adverse effects ; Trigger Finger Disorder/drug therapy ; Incidence ; Retrospective Studies ; Steroids ; Adrenal Cortex Hormones/therapeutic use
    Chemical Substances Aromatase Inhibitors ; Anastrozole (2Z07MYW1AZ) ; Letrozole (7LKK855W8I) ; Steroids ; Adrenal Cortex Hormones
    Language English
    Publishing date 2022-12-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 208012-6
    ISSN 1529-4242 ; 0032-1052 ; 0096-8501
    ISSN (online) 1529-4242
    ISSN 0032-1052 ; 0096-8501
    DOI 10.1097/PRS.0000000000010087
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Prophylactic Muscle Flaps Decrease Wound Complication Rates in Patients with Oncologic Spine Disease.

    Dalton, Tara / Darner, Grant / McCray, Edwin / Price, Meghan / Baëta, Cesar / Erickson, Melissa / Karikari, Isaac O / Abd-El-Barr, Muhammad M / Goodwin, C Rory / Brown, David A

    Plastic and reconstructive surgery

    2023  Volume 153, Issue 1, Page(s) 221–231

    Abstract: Background: Patients with oncologic spine disease face a high systemic illness burden and often require surgical intervention to alleviate pain and maintain spine stability. Wound healing complications are the most common reason for reoperation in this ... ...

    Abstract Background: Patients with oncologic spine disease face a high systemic illness burden and often require surgical intervention to alleviate pain and maintain spine stability. Wound healing complications are the most common reason for reoperation in this population and are known to impact quality of life and initiation of adjuvant therapy. Prophylactic muscle flap (MF) closure is known to reduce wound healing complications in high-risk patients; however, the efficacy in oncologic spine patients is not well established.
    Methods: A collaboration at our institution presented an opportunity to study the outcomes of prophylactic MF closure. The authors performed a retrospective cohort study of patients who underwent MF closure versus a cohort who underwent non-MF closure in the preceding time. Demographic and baseline health data were collected, as were postoperative wound complication data.
    Results: A total of 166 patients were enrolled, including 83 patients in the MF cohort and 83 control patients. Patients in the MF group were more likely to smoke ( P = 0.005) and had a higher incidence of prior spine irradiation ( P = 0.002). Postoperatively, five patients (6%) in the MF group developed wound complications, compared with 14 patients (17%) in the control group ( P = 0.028). The most common overall complication was wound dehiscence requiring conservative therapy, which occurred in six control patients (7%) and one MF patient (1%) ( P = 0.053).
    Conclusions: Prophylactic MF closure during oncologic spine surgery significantly reduces the wound complication rate. Future studies should examine the precise patient population that stands to benefit most from this intervention.
    Clinical question/level of evidence: Therapeutic, III.
    MeSH term(s) Humans ; Plastic Surgery Procedures/adverse effects ; Retrospective Studies ; Quality of Life ; Treatment Outcome ; Spinal Diseases/surgery ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/prevention & control ; Muscles/surgery ; Surgical Wound Infection/epidemiology ; Surgical Wound Infection/etiology ; Surgical Wound Infection/prevention & control
    Language English
    Publishing date 2023-04-20
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
    ZDB-ID 208012-6
    ISSN 1529-4242 ; 0032-1052 ; 0096-8501
    ISSN (online) 1529-4242
    ISSN 0032-1052 ; 0096-8501
    DOI 10.1097/PRS.0000000000010568
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Activity of diphenyl ether benzyl amines against Human African Trypanosomiasis.

    Hagen, James P / Darner, Grant / Anderson, Samuel / Higgins, Katie / Leas, Derek A / Mitra, Ananya / Mashinson, Victoria / Wol, Tasloach / Vera-Esquivel, Carlos / Belter, Bret / Cal, Monica / Kaiser, Marcel / Wallick, Alexander / Warner, Rosalie C / Davis, Paul H

    Bioorganic chemistry

    2020  Volume 97, Page(s) 103590

    Abstract: Insect-borne parasite Trypanosoma brucei plagues humans and other animals, eliciting the disease Human African trypanosomiasis, also known as African sleeping sickness. This disease poses the biggest threat to the people in Sub-Saharan Africa. Given the ... ...

    Abstract Insect-borne parasite Trypanosoma brucei plagues humans and other animals, eliciting the disease Human African trypanosomiasis, also known as African sleeping sickness. This disease poses the biggest threat to the people in Sub-Saharan Africa. Given the high toxicity and difficulties with administration of currently available drugs, a novel treatment is needed. Building on known Human African trypanosomiasis structure-activity relationship (SAR), we now describe a number of functionally simple diphenyl ether analogs which give low micromolar activity (IC
    MeSH term(s) Benzylamines/chemistry ; Benzylamines/pharmacology ; Cell Line ; Humans ; Phenyl Ethers/chemistry ; Phenyl Ethers/pharmacology ; Structure-Activity Relationship ; Trypanocidal Agents/chemistry ; Trypanocidal Agents/pharmacology ; Trypanosoma brucei rhodesiense/drug effects ; Trypanosomiasis, African/drug therapy ; Trypanosomiasis, African/parasitology
    Chemical Substances Benzylamines ; Phenyl Ethers ; Trypanocidal Agents
    Language English
    Publishing date 2020-01-27
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 120080-x
    ISSN 1090-2120 ; 0045-2068
    ISSN (online) 1090-2120
    ISSN 0045-2068
    DOI 10.1016/j.bioorg.2020.103590
    Database MEDical Literature Analysis and Retrieval System OnLINE

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