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Article ; Online: Retrograde Flow of Fluid Through the Nasolacrimal Duct System Under General Anesthesia: A Case Report.

Dhoon, Taizoon Q / Lam, Isaac / Kwan, Claire / Huang, Jennifer / McIntyre, Jon / Mehta, Mitul

A&A practice

2024 Volume 18, Issue 3, Page(s) e01763

Abstract: This case report describes a rare incident of fluid exhibiting retrograde flow from the nasopharynx through the nasolacrimal duct and accumulating within the eye guard while under general anesthesia. The patient was in a steep Trendelenburg position for ... ...

Abstract	This case report describes a rare incident of fluid exhibiting retrograde flow from the nasopharynx through the nasolacrimal duct and accumulating within the eye guard while under general anesthesia. The patient was in a steep Trendelenburg position for several hours and received multiple liters of intravenous fluid. The patient did not have a history of sinusitis, sinus surgery, cocaine use, dacryostenosis and dacryocystitis, or nasolacrimal duct irrigation and probing. This case provides insight into the potential ophthalmic implications of surgical and anesthetic management. While the patient fortunately had no complications, this case also underscores the importance of intraoperative vigilance.
MeSH term(s)	Humans ; Nasolacrimal Duct/surgery ; Anesthesia, General ; Face ; Head-Down Tilt ; Wakefulness
Language	English
Publishing date	2024-02-29
Publishing country	United States
Document type	Case Reports ; Journal Article
ISSN	2575-3126
ISSN (online)	2575-3126
DOI	10.1213/XAA.0000000000001763
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Article: Systolic Arterial Pressure Control Using an Automated Closed-Loop System for Vasopressor Infusion during Intermediate-to-High-Risk Surgery: A Feasibility Study.

Rinehart, Joseph / Desebbe, Olivier / Berna, Antoine / Lam, Isaac / Coeckelenbergh, Sean / Cannesson, Maxime / Joosten, Alexandre

Journal of personalized medicine

2022 Volume 12, Issue 10

Abstract: Introduction: Vasopressor infusions are essential in treating and preventing intraoperative hypotension. Closed-loop vasopressor therapy outperforms clinicians when the target is set at a mean arterial pressure (MAP) baseline, but little is known on the ... ...

Abstract	Introduction: Vasopressor infusions are essential in treating and preventing intraoperative hypotension. Closed-loop vasopressor therapy outperforms clinicians when the target is set at a mean arterial pressure (MAP) baseline, but little is known on the performance metrics of closed-loop vasopressor infusions when systolic arterial pressure (SAP) is the controlled variable. Methods: Patients undergoing intermediate- to high-risk abdominal surgery were included in this prospective cohort feasibility study. All patients received norepinephrine infusion through a computer controlled closed-loop system that targeted SAP at 130 mmHg. The primary objective was to determine the percent of case time in hypotension or under target defined as SAP below 10% of the target (SAP < 117 mmHg). Secondary objectives were the percent of case time “above target” (SAP > 10% of the target or >143 mmHg) and “in target” (within 10% of the SAP target or SAP between 117 and 143 mmHg). Results: A total of 12 patients were included. The closed-loop system infused norepinephrine for a median of 94.6% (25−75th percentile: 90.0−98.0%) of case time. The percentage of case time in hypotension or under target was only 1.8% (0.9−3.6%). The percentages of case time “above target” and “in target” were 4.7% (3.2−7.5%) and 92.4% (90.1−96.3%), respectively. Conclusions: This closed-loop vasopressor system minimizes intraoperative hypotension and maintains SAP within 10% of the target range for >90% of the case time in patients undergoing intermediate- to high-risk abdominal surgery.
Language	English
Publishing date	2022-09-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662248-8
ISSN	2075-4426
ISSN	2075-4426
DOI	10.3390/jpm12101554
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Article ; Online: Spinal and paraspinal inflammatory reactions after epidural steroid injection in a patient taking disease-modifying antirheumatic drugs.

Patel, Prachi M / Lam, Isaac / Liu, Benjamin P / Benzon, Honorio T

Regional anesthesia and pain medicine

2020 Volume 46, Issue 4, Page(s) 358–361

Abstract: BackgroundDisease-modifying anti-rheumatic drugs (DMARDs) are used in the management of rheumatoid arthritis (RA) and are classified as conventional DMARDs and biologic agents. A concern with DMARDs is the increased risk of infection after surgery. A ... ...

Abstract	BackgroundDisease-modifying anti-rheumatic drugs (DMARDs) are used in the management of rheumatoid arthritis (RA) and are classified as conventional DMARDs and biologic agents. A concern with DMARDs is the increased risk of infection after surgery. A practice advisory from the American Society of Anesthesiologists recommend alternatives to neuraxial injections in patients who are immunocompromized. We describe a patient who was on several DMARDs and developed inflammatory reactions in her bilateral paraspinal muscles and lumbar spine after an epidural steroid injection (ESI). CASE PRESENTATION: The patient was a 79-year-old woman; she was taking methotrexate, adalimumab and prednisone for her RA. She had a left L5-S1 paramedian ESI for her L5 radiculitis. After relief of her back and radicular pain for 5 weeks, she had an acute exacerbation of her back pain. MRI showed bilateral paraspinal fluid accumulations and enhancement in her ligamentum flavum. Cultures of the aspirated fluid and biopsy specimens were negative for fungal, aerobic and anaerobic organisms. A repeat MRI 2 months later showed diminution of the fluid collection but with a new fluid accumulation near the left L4-5 facet and left L4 pedicle. Repeat cultures and gram stain of the specimens taken from the pedicle and the paraspinal muscles were negative. The patient was followed by her rheumatologist and in the pain clinic until resolution of her symptoms. CONCLUSIONS: Several society guidelines recommend the continuation of methotrexate but stoppage of the biologic DMARDS before surgery. The occurrence of an intense inflammatory reaction after an ESI in our patient calls for additional research on the subject and shared decision-making between the pain physician, patient and rheumatologist especially in patients on several DMARDs.
MeSH term(s)	Aged ; Antirheumatic Agents ; Female ; Humans ; Lumbar Vertebrae ; Lumbosacral Region ; Pain ; Steroids
Chemical Substances	Antirheumatic Agents ; Steroids
Language	English
Publishing date	2020-12-21
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	1425299-5
ISSN	1532-8651 ; 1098-7339 ; 0146-521X
ISSN (online)	1532-8651
ISSN	1098-7339 ; 0146-521X
DOI	10.1136/rapm-2020-102061
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Article ; Online: Anti-TNF agents and potential effects on male fertility: are men being counseled?

Cooley, Lauren Folgosa / Wren, James / Keeter, Mary Kate / Lam, Isaac / Bennett, Nelson / Brannigan, Robert E

BMC urology

2020 Volume 20, Issue 1, Page(s) 111

Abstract: Background: Adult men with autoimmune conditions are commonly prescribed anti-tumor necrosis factor (anti-TNF) agents; however, there is a paucity of quality evidence as to their effect on male fertility (e.g. semen parameters and sperm quality). Our ... ...

Abstract	Background: Adult men with autoimmune conditions are commonly prescribed anti-tumor necrosis factor (anti-TNF) agents; however, there is a paucity of quality evidence as to their effect on male fertility (e.g. semen parameters and sperm quality). Our objective was to determine if men with autoimmune conditions are being counseled regarding the unknown reproductive effects of anti-TNF agents prior to initiation of therapy. Methods: A retrospective analysis of 1010 male patients age 18-45 who were prescribed an anti-TNF agent were assessed for (1) receipt of counseling regarding potential reproductive effects; (2) screening for anatomic or laboratory abnormalities associated with infertility; (3) election for sperm cryopreservation. Results: Only 10.3% of men received counseling, and this was not associated with age (p = 0.77). Those who received counseling were significantly more likely to have a genitourinary exam performed, be assessed for presence of a varicocele, be asked about or endorse low libido or erectile dysfunction, have a testosterone, LH, FSH, or prolactin level checked, and have a semen analysis performed (all, p < 0.0001). Rates of sperm cryopreservation were low, but statistically higher in men who received counseling (5.77% (+) counseling, 1.10% (-) counseling) (p = 0.002). Conclusions: The limited current literature lacks a consensus regarding the short- and long-term male reproductive effects of anti-TNF therapy. Despite this lack of clarity, rates of pre-initiation counseling were low. Rates of sperm cryopreservation, while improved in the counseled group remained low, suggesting prescribing physicians may be unaware of this option for patients.
MeSH term(s)	Adolescent ; Adult ; Autoimmune Diseases/drug therapy ; Cryopreservation ; Directive Counseling ; Fertility/drug effects ; Humans ; Infertility, Male/chemically induced ; Infertility, Male/prevention & control ; Male ; Retrospective Studies ; Spermatozoa ; Tumor Necrosis Factor-alpha/antagonists & inhibitors ; Young Adult
Chemical Substances	Tumor Necrosis Factor-alpha
Language	English
Publishing date	2020-07-27
Publishing country	England
Document type	Journal Article
ZDB-ID	2059857-9
ISSN	1471-2490 ; 1471-2490
ISSN (online)	1471-2490
ISSN	1471-2490
DOI	10.1186/s12894-020-00658-7
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Article ; Online: Macrophage phagocytosis alters the MRI signal of ferumoxytol-labeled mesenchymal stromal cells in cartilage defects.

Nejadnik, Hossein / Lenkov, Olga / Gassert, Florian / Fretwell, Deborah / Lam, Isaac / Daldrup-Link, Heike E

Scientific reports

2016 Volume 6, Page(s) 25897

Abstract: Human mesenchymal stem cells (hMSCs) are a promising tool for cartilage regeneration in arthritic joints. hMSC labeling with iron oxide nanoparticles enables non-invasive in vivo monitoring of transplanted cells in cartilage defects with MR imaging. ... ...

Abstract	Human mesenchymal stem cells (hMSCs) are a promising tool for cartilage regeneration in arthritic joints. hMSC labeling with iron oxide nanoparticles enables non-invasive in vivo monitoring of transplanted cells in cartilage defects with MR imaging. Since graft failure leads to macrophage phagocytosis of apoptotic cells, we evaluated in vitro and in vivo whether nanoparticle-labeled hMSCs show distinct MR signal characteristics before and after phagocytosis by macrophages. We found that apoptotic nanoparticle-labeled hMSCs were phagocytosed by macrophages while viable nanoparticle-labeled hMSCs were not. Serial MRI scans of hMSC transplants in arthritic joints of recipient rats showed that the iron signal of apoptotic, nanoparticle-labeled hMSCs engulfed by macrophages disappeared faster compared to viable hMSCs. This corresponded to poor cartilage repair outcomes of the apoptotic hMSC transplants. Therefore, rapid decline of iron MRI signal at the transplant site can indicate cell death and predict incomplete defect repair weeks later. Currently, hMSC graft failure can be only diagnosed by lack of cartilage defect repair several months after cell transplantation. The described imaging signs can diagnose hMSC transplant failure more readily, which could enable timely re-interventions and avoid unnecessary follow up studies of lost transplants.
Language	English
Publishing date	2016-05-13
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/srep25897
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Article ; Online: Inconsistent Adoption of World Health Organization V (2010) Semen Analysis Reference Ranges in the United States Eight Years After Publication.

Lewis, Kevin C / Lam, Isaac / Nieb, Jacob / Lam, Grace / Desai, Anuj S / Mazur, Daniel J / Kahn, Barbara / Keeter, Mary Kate / Tatem, Alex / Hehemann, Marah / Frainey, Brendan T / Bennett, Jr Nelson / Brannigan, Robert E

Urology

2018 Volume 126, Page(s) 96–101

Abstract: Objective: To determine the percentage of laboratories in the United States that have adopted the World Health Organization 2010 (WHO 5) semen analysis (SA) reference values 6years after their publication.: Methods: Laboratories were identified via 3 ...

Abstract	Objective: To determine the percentage of laboratories in the United States that have adopted the World Health Organization 2010 (WHO 5) semen analysis (SA) reference values 6years after their publication. Methods: Laboratories were identified via 3 approaches: using the Clinical Laboratory Improvement Amendments (CLIA) website, the CDC's 2015 Assisted Reproductive Technology Fertility Clinical Success Rate Report, and automated web searches. Laboratories were contacted by phone or email to obtain de-identified SA reports and reference ranges. Results: We contacted 617 laboratories in 46 states, of which 208 (26.7%) laboratories in 45 states were included in our analysis. 132 (63.5%) laboratories used WHO 5 criteria, 57 (27.4%) used WHO 4 criteria, and 19 (9.1%) used other criteria. WHO 5 criteria adoption rates varied by geographic region, ranging from 87.5% (35/40) in the Midwest to 50.0% (33/66) in the West. There was a greater adoption rate of WHO 5 reference values in academic affiliated (23/26, 88.5%) compared to non-academic affiliated laboratories (110/182, 60.4%) (P = .028). Conclusion: While the majority of laboratories have adopted WHO 5 criteria following its release 6years ago, a large percentage (36.5%) use what is now considered outdated criteria. This variability could result in the characterization of a male's semen values as being "within reference range" at one center and "outside of reference range" at another. This inconsistency in classification may result in confusion for the both patient and physician and potentially shift the burden of infertility evaluation and treatment to the female partner.
MeSH term(s)	Clinical Laboratory Techniques/standards ; Humans ; Male ; Publishing ; Reference Values ; Semen Analysis/statistics & numerical data ; Time Factors ; United States ; World Health Organization
Language	English
Publishing date	2018-12-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	192062-5
ISSN	1527-9995 ; 0090-4295
ISSN (online)	1527-9995
ISSN	0090-4295
DOI	10.1016/j.urology.2018.09.041
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Article: Transgenerational retention and maternal transfer of selenium in Daphnia magna.

Lam, Isaac K S / Wang, Wen-Xiong

Environmental toxicology and chemistry

2006 Volume 25, Issue 9, Page(s) 2519–2525

Abstract: We examined transgenerational retention and maternal transfer of selenium (Se) in three consecutive generations (F0, F1, and F2) of Daphnia magna. The F0 generation was exposed to dietary selenium (as selenite) only, and the F1 and F2 generations ... ...

Abstract	We examined transgenerational retention and maternal transfer of selenium (Se) in three consecutive generations (F0, F1, and F2) of Daphnia magna. The F0 generation was exposed to dietary selenium (as selenite) only, and the F1 and F2 generations received only the maternally derived selenium from F0 and F1, respectively. Algal food Scenedesmus obilquus was radiolabeled with 0.56 microM Se, and the finial Se concentration in the algae was 115.6 microg Se/g dry weight. After 10 d feeding, the initial Se concentration in the F0 prior to depuration was 0.72 microg Se/g wet weight. The Se retention within the same generation was comparable at different food concentrations, but it increased across the consecutive generations regardless of the food concentration, suggesting that Se elimination was dependent on the source of Se accumulation (dietary vs maternally derived). Retention was also comparable among different batches of offspring within the same generation. Reproduction rate increased with increasing food concentration but decreased across the successive batches in F1. The 10-d overall maternal transfer efficiency increased with increasing food concentration in all generations. Approximately 19 to 24% of Se in F0 was transferred maternally to F1 during reproductive events, but the-efficiency decreased considerably from F1 to F2. Maternal transfer also decreased in the later batches of F1. The transfer efficiency to each neonate showed a negative relationship with food concentration in both F0 and F1, suggesting that the Se transfer to the offspring was compromised by the reproduction rate. We concluded that dietary-derived Se (from F0) was more efficiently transferred to the offspring (F1) than the maternally derived Se (from F1) transferred to F2; thus it is necessary to separate the dietary and maternal contributions to the overall Se accumulation in Daphnia.
MeSH term(s)	Animals ; Daphnia/metabolism ; Female ; Reproduction/drug effects ; Scenedesmus ; Selenium/metabolism ; Sodium Selenite/metabolism ; Water Pollutants, Chemical/metabolism
Chemical Substances	Water Pollutants, Chemical ; Selenium (H6241UJ22B) ; Sodium Selenite (HIW548RQ3W)
Language	English
Publishing date	2006-08-02
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	46234-2
ISSN	1552-8618 ; 0730-7268
ISSN (online)	1552-8618
ISSN	0730-7268
DOI	10.1897/05-631r.1
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Article: Accumulation and elimination of aqueous and dietary silver in Daphnia magna.

Lam, Isaac K S / Wang, Wen-Xiong

Chemosphere

2006 Volume 64, Issue 1, Page(s) 26–35

Abstract: The dissolved uptake, dietary assimilation, and efflux of Ag in a freshwater cladoceran, Daphnia magna, were measured under different laboratory conditions. The dissolved uptake rate of Ag was proportional to the ambient Ag concentration, but the ... ...

Abstract	The dissolved uptake, dietary assimilation, and efflux of Ag in a freshwater cladoceran, Daphnia magna, were measured under different laboratory conditions. The dissolved uptake rate of Ag was proportional to the ambient Ag concentration, but the accumulation was highly variable due to the sorption of Ag onto the daphnid bodies. The ambient Na(+) but not the ambient K(+) concentration significantly decreased the dissolved uptake of Ag, suggesting a competitive uptake of Ag(+) with Na(+). The dietary assimilation efficiencies (AEs) of Ag are dependent on the concentration of the algal food available to D. magna. The AE was as low as 2% when the food concentration reached the saturation levels. In contrast, the Ag concentrations in the algae did not significantly affect the Ag AE in D. magna. The efflux rate constant of diet-incorporated Ag was twice that through dissolved uptake. The elimination of Ag was further separated into different compartments (excretion, egestion, molting, and reproduction) in the juveniles and adults after accumulation from dissolved and dietary sources. Regeneration into the dissolved phase was the predominant pathway by which the incorporated Ag was lost from D. magna, regardless of the exposure pathway. In contrast to the essential metals or Hg, there was minimal maternal transfer of Ag from the mothers to the offspring. By employing the biokinetic model, we further showed that water is a dominant pathway for Ag accumulation in D. magna. Trophic transfer is less significant primarily because of the low Ag AE when the food concentration reached the saturation levels.
MeSH term(s)	Animals ; Animals, Newborn ; Chlamydomonas reinhardtii ; Daphnia/metabolism ; Diet ; Models, Biological ; Silver/metabolism ; Water Pollutants, Chemical/metabolism
Chemical Substances	Water Pollutants, Chemical ; Silver (3M4G523W1G)
Language	English
Publishing date	2006-06
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	120089-6
ISSN	1879-1298 ; 0045-6535 ; 0366-7111
ISSN (online)	1879-1298
ISSN	0045-6535 ; 0366-7111
DOI	10.1016/j.chemosphere.2005.12.023
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Article ; Online: Levels of trace elements, methylmercury and polybrominated diphenyl ethers in foraging green turtles in the South China region and their conservation implications.

Ng, Connie Ka Yan / Lam, James Chung Wah / Zhang, Xiao Hua / Gu, He Xiang / Li, Tsung Hsien / Ye, Min Bin / Xia, Zhong Rong / Zhang, Fei Yan / Duan, Jin Xia / Wang, Wen Xiong / Lam, Isaac Kam Sum / Balazs, George H / Lam, Paul K S / Murphy, Margaret B

Environmental pollution (Barking, Essex : 1987)

2018 Volume 234, Page(s) 735–742

Abstract: Sea turtles are globally endangered and face daily anthropogenic threats, including pollution. However, there is a lack of ecotoxicological information on sea turtles, especially in the Asia-Pacific region. This study aims to determine pollutant levels ... ...

Abstract	Sea turtles are globally endangered and face daily anthropogenic threats, including pollution. However, there is a lack of ecotoxicological information on sea turtles, especially in the Asia-Pacific region. This study aims to determine pollutant levels of foraging green turtles (Chelonia mydas) in South China, including Hong Kong, Guangdong and Taiwan, as a basis for their conservation. Scute, liver and muscle tissues of stranded green turtles were analysed for levels of 17 trace elements and methylmercury (MeHg) (n = 86 for scute and n = 14 for liver) and polybrominated diphenyl ethers (PBDEs) (n = 11 for muscle and n = 13 for liver). Ten-fold higher levels of Pb, Ba, V and Tl and 40-fold greater Cd levels were measured in green turtle livers in South China relative to other studies conducted over 10 years ago. Measured PBDE levels were also 27-fold and 50-fold greater than those reported in Australia and Japan. These results warrant further investigation of potential toxicological risks to green turtles in South China and their source rookeries in Malaysia, Micronesia, Indonesia, Marshall Islands, Japan and Taiwan. Research should target monitoring pollutant levels in sea turtles within the West Pacific/Southeast Asia regional management unit spanning East Asia to Southeast Asia to fill in knowledge gaps, in particular in areas such as Thailand, Vietnam, Indonesia, Malaysia and the Philippines where less or no data is available and where foraging grounds of sea turtles have been identified.
MeSH term(s)	Animals ; Asia, Southeastern ; Australia ; Barium/analysis ; Cadmium/analysis ; China ; Far East ; Halogenated Diphenyl Ethers/analysis ; Lead/analysis ; Liver/chemistry ; Methylmercury Compounds/analysis ; Muscles/chemistry ; Thallium/analysis ; Trace Elements/analysis ; Turtles/physiology ; Vanadium/analysis
Chemical Substances	Halogenated Diphenyl Ethers ; Methylmercury Compounds ; Trace Elements ; Cadmium (00BH33GNGH) ; Vanadium (00J9J9XKDE) ; Barium (24GP945V5T) ; Lead (2P299V784P) ; Thallium (AD84R52XLF)
Language	English
Publishing date	2018-03
Publishing country	England
Document type	Journal Article
ZDB-ID	280652-6
ISSN	1873-6424 ; 0013-9327 ; 0269-7491
ISSN (online)	1873-6424
ISSN	0013-9327 ; 0269-7491
DOI	10.1016/j.envpol.2017.11.100
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