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  1. Article: Clinical Effectiveness - Rapid Technique for Antibiotic Selection.

    Markowitz, Arnold

    Clinical laboratory

    2019  Volume 65, Issue 9

    Abstract: Background: Antimicrobial resistance is a growing problem. The current process for determining antibiotic sensitivities is time consuming and often leaves patients waiting for results while using the wrong antibiotic. Reducing inappropriate antibiotic ... ...

    Abstract Background: Antimicrobial resistance is a growing problem. The current process for determining antibiotic sensitivities is time consuming and often leaves patients waiting for results while using the wrong antibiotic. Reducing inappropriate antibiotic use diminishes the development of resistance and reduces expenses. The objective of the study was to determine if a simplified laboratory process using direct plating techniques in association with class disks to identify antibiotic resistance is a viable option to reduce the time it takes to minimize the use of ineffective antibiotics.
    Methods: A tutored office technician collected specimens. Cultures were performed on traditional laboratory media. They were concurrently submitted as routine cultures to our usual certified outpatient laboratory, Quest Diagnostics Inc.
    Results: We found that in this case series an average of 33 hours was saved over conventional microbial culture techniques with 16/16 (100%) concurrence for UTIs and 57.6 hours saved with 9/10 (90%) comparable results for wound cultures.
    Conclusions: Using this abbreviated culture technique and reporting resistance rather than sensitivity, not only can save time, but inappropriate antibiotic use may be avoided.
    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Clinical Laboratory Techniques/methods ; Drug Resistance, Microbial/drug effects ; Humans ; Reproducibility of Results ; Sensitivity and Specificity ; Time Factors ; Treatment Outcome ; Urinary Tract Infections/diagnosis ; Urinary Tract Infections/drug therapy ; Urinary Tract Infections/microbiology ; Wound Infection/diagnosis ; Wound Infection/drug therapy ; Wound Infection/microbiology
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2019-10-16
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1307629-2
    ISSN 1433-6510 ; 0941-2131
    ISSN 1433-6510 ; 0941-2131
    DOI 10.7754/Clin.Lab.2019.180812
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  2. Article: The use of homogenous bone grafts in mandibular reconstruction.

    MARKOWITZ, A

    American journal of surgery

    2003  Volume 96, Issue 6, Page(s) 755–762

    MeSH term(s) Bone Transplantation ; Humans ; Mandible/surgery ; Mandibular Reconstruction
    Language English
    Publishing date 2003-04-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2953-1
    ISSN 1879-1883 ; 0002-9610
    ISSN (online) 1879-1883
    ISSN 0002-9610
    DOI 10.1016/0002-9610(58)90994-2
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  3. Article ; Online: Trends in Measures of Child and Adolescent Well-being in the US From 2000 to 2019.

    Anderson, Nathaniel W / Eisenberg, Daniel / Halfon, Neal / Markowitz, Anna / Moore, Kristin Anderson / Zimmerman, Frederick J

    JAMA network open

    2022  Volume 5, Issue 10, Page(s) e2238582

    Abstract: Importance: Improving child and adolescent well-being is a critical public health goal, yet monitoring of this measure at the national level remains limited. Composite indices aggregate existing indicators from population data sources, but these indices ...

    Abstract Importance: Improving child and adolescent well-being is a critical public health goal, yet monitoring of this measure at the national level remains limited. Composite indices aggregate existing indicators from population data sources, but these indices currently have weaknesses that may inhibit widespread use.
    Objective: To apply a novel, more child-centric index method to document changes in overall child and adolescent well-being in the US from 2000 to 2019, assess which states and racial and ethnic subpopulations experienced the greatest inequities in well-being, and identify the specific components associated with changes in the index over time.
    Design, setting, and participants: This cross-sectional study applied the Child and Adolescent Thriving Index 1.0 to population-level data from 2000 to 2019 from several data sources. The area-based sampling frame for each of the component data sources allowed for nationally representative estimates for every year of the study period. The indices for every state and by race and ethnicity were also calculated. Due to the scope and breadth of the index components from across the life course, the Child and Adolescent Thriving Index 1.0 is intended to approximate the well-being of persons up to age 17 years. Data were analyzed from June 7, 2021, to March 17, 2022.
    Exposures: Time in years.
    Main outcomes and measures: The Child and Adolescent Thriving Index 1.0 is a weighted mean of 11 indicators intended to proxy well-being. The index comprises 11 components: non-low birth weight in neonates, preschool attendance in children aged 3 to 4 years, reading proficiency in fourth-grade students, math proficiency in eighth-grade students, food security in children younger than 18 years, general health status, nonobesity in high school students, nonsmoking in adolescents aged 12 to 17 years, non-marijuana use in adolescents aged 12 to 17 years, high school graduation in young adults aged 18 to 21 years, and nonarrest rate in children aged 10 to 17 years. The index ranges from 0 to 1, with 0 indicating minimum and 1 indicating maximum possible well-being at the population level.
    Results: The Child and Adolescent Thriving Index 1.0 was applied to data from 12 320 national, state, and racial and ethnic population-level estimates. Over the study period, the Child and Adolescent Thriving Index 1.0 score increased from 0.780 points in 2000 to 0.843 points in 2019. Despite some convergence in geographic and racial and ethnic disparities, inequities were still present in 2019 in the South (-0.021 points) compared with the Northeast and among American Indian or Alaska Native (-0.079 points), Black (-0.053 points), and Latinx (-0.047 points) children and adolescents compared with White youths. Index components most associated with the overall increases in index scores of well-being were high school graduation rate (+0.028 units) and nonsmoking in adolescents (+0.022 units), amounting to 80.6% of the total increase.
    Conclusions and relevance: Results of this study suggest that child and adolescent well-being scores increased from 2000 to 2019, but substantial work remains to address persistent inequities across states and racial and ethnic populations. The newly developed Child and Adolescent Thriving Index 1.0 may be used in future work to evaluate which public policy types (economic, social, health care, housing, or education) are associated with higher levels of well-being.
    MeSH term(s) Young Adult ; Adolescent ; Infant, Newborn ; Child, Preschool ; Humans ; Adolescent Health ; Cross-Sectional Studies ; Ethnicity ; Health Status ; Educational Status
    Language English
    Publishing date 2022-10-03
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S.
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2022.38582
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  4. Article: Utility of the full root bioprosthesis in surgery for complex aortic valve-ascending aortic disease.

    Markowitz, A

    Seminars in thoracic and cardiovascular surgery

    2001  Volume 13, Issue 4 Suppl 1, Page(s) 12–15

    Abstract: The objective of this study was to demonstrate the use of the full root bioprosthesis (Medtronic Freestyle) in the patient with complex aortic valve-ascending disease. Of 148 patients undergoing stentless aortic valve replacement since 4/98, 22 required ... ...

    Abstract The objective of this study was to demonstrate the use of the full root bioprosthesis (Medtronic Freestyle) in the patient with complex aortic valve-ascending disease. Of 148 patients undergoing stentless aortic valve replacement since 4/98, 22 required concomitant replacement of the entire ascending aorta with a Dacron graft (beveled to include hemi-arch) for either "porcelain" aorta (8) or diffuse aneurysmal dilatation (14): 17/22 had aortic stenosis, 4/22 had aortic insufficiency, and 1 had bioprosthetic degeneration. All patients had right axillary cannulation, circulatory arrest at 18 C, and retrocerebral perfusion through the superior vena cava. Valve sizes included 23 mm (7), 25 mm (2), and 27 mm (13). Average age was 69.5 years, average intensive care unit stay was 64 hours, and average postoperative length of stay was 6.5 days. Although the initial intent was full root replacement, 7 patients had calcified coronary ostia precluding reimplantation. Subcoronary implantation techniques were modified to interdigitate the outflow suture lines between and through islands of calcium buttressed with small pericardial pledgets on the outside of the native aorta. All valves demonstrated either no or trace aortic regurgitation on pre-discharge transesophageal echocardiography, 30-day mortality was 0, and there were no neurologic sequelae. The full root bioprosthesis has great utility in surgery for complex aortic valve-ascending aortic disease. Axillary artery cannulation and retrograde cerebral perfusion provide a reproducible neurologically safe approach in this group of patients at high risk for intraoperative neurologic morbidity.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Aortic Diseases/surgery ; Aortic Valve/diagnostic imaging ; Aortic Valve/surgery ; Aortic Valve Stenosis/surgery ; Bioprosthesis ; Female ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation/methods ; Humans ; Intraoperative Complications ; Length of Stay ; Male ; Middle Aged ; Postoperative Complications ; Prosthesis Design ; Radiography
    Language English
    Publishing date 2001-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1038278-1
    ISSN 1532-9488 ; 1043-0679
    ISSN (online) 1532-9488
    ISSN 1043-0679
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    Zs.A 2747: Show issues Location:
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  5. Article ; Online: Clinical, pathologic, and genomic characteristics of two pediatric glioneuronal tumors with a CLIP2::MET fusion.

    Chapman, Nicholas / Greenwald, Joshua / Suddock, Jolee / Xu, Dong / Markowitz, Alexander / Humphrey, Maeve / Cotter, Jennifer A / Krieger, Mark D / Hawes, Debra / Ji, Jianling

    Acta neuropathologica communications

    2024  Volume 12, Issue 1, Page(s) 63

    Abstract: Integration of molecular data with histologic, radiologic, and clinical features is imperative for accurate diagnosis of pediatric central nervous system (CNS) tumors. Whole transcriptome RNA sequencing (RNAseq), a genome-wide and non-targeted approach, ... ...

    Abstract Integration of molecular data with histologic, radiologic, and clinical features is imperative for accurate diagnosis of pediatric central nervous system (CNS) tumors. Whole transcriptome RNA sequencing (RNAseq), a genome-wide and non-targeted approach, allows for the detection of novel or rare oncogenic fusion events that contribute to the tumorigenesis of a substantial portion of pediatric low- and high-grade glial and glioneuronal tumors. We present two cases of pediatric glioneuronal tumors occurring in the occipital region with a CLIP2::MET fusion detected by RNAseq. Chromosomal microarray studies revealed copy number alterations involving chromosomes 1, 7, and 22 in both tumors, with Case 2 having an interstitial deletion breakpoint in the CLIP2 gene. By methylation profiling, neither tumor had a match result, but both clustered with the low-grade glial/glioneuronal tumors in the UMAP. Histologically, in both instances, our cases displayed characteristics of a low-grade tumor, notably the absence of mitotic activity, low Ki-67 labeling index and the lack of necrosis and microvascular proliferation. Glial and neuronal markers were positive for both tumors. Clinically, both patients achieved clinical stability post-tumor resection and remain under regular surveillance imaging without adjuvant therapy at the last follow-up, 6 months and 3 years, respectively. This is the first case report demonstrating the presence of a CLIP2::MET fusion in two pediatric low-grade glioneuronal tumors (GNT). Conservative clinical management may be considered for patients with GNT and CLIP2:MET fusion in the context of histologically low-grade features.
    MeSH term(s) Child ; Child, Preschool ; Female ; Humans ; Male ; Brain Neoplasms/genetics ; Brain Neoplasms/pathology ; Brain Neoplasms/diagnostic imaging ; Glioma/genetics ; Glioma/pathology ; Glioma/diagnostic imaging ; Microtubule-Associated Proteins/genetics ; Oncogene Proteins, Fusion/genetics ; Proto-Oncogene Proteins c-met/genetics
    Chemical Substances MET protein, human (EC 2.7.10.1) ; Microtubule-Associated Proteins ; Oncogene Proteins, Fusion ; Proto-Oncogene Proteins c-met (EC 2.7.10.1) ; cytoplasmic linker protein 115
    Language English
    Publishing date 2024-04-22
    Publishing country England
    Document type Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2715589-4
    ISSN 2051-5960 ; 2051-5960
    ISSN (online) 2051-5960
    ISSN 2051-5960
    DOI 10.1186/s40478-024-01776-1
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  6. Article ; Online: Development of a Longitudinal National Football League Injury and Injury Impacts (L-NFL-III) Database.

    Markowitz, J S / Papadopoulos, G / Markowitz, A

    Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research

    2014  Volume 17, Issue 7, Page(s) A728

    Language English
    Publishing date 2014-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1471745-1
    ISSN 1524-4733 ; 1098-3015
    ISSN (online) 1524-4733
    ISSN 1098-3015
    DOI 10.1016/j.jval.2014.08.068
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  7. Article ; Online: New Insights Into Understanding Rotor Versus Focal Activation in Patients With Persistent Atrial Fibrillation.

    Lee, Seungyup / Khrestian, Celeen M / Sahadevan, Jayakumar / Markowitz, Alan / Waldo, Albert L

    JACC. Clinical electrophysiology

    2021  Volume 7, Issue 7, Page(s) 909–919

    Abstract: Objectives: This study was to test the hypotheses that: 1) when using phase analysis, repetitive Wannabe re-entry produces a phase singularity point (i.e., a rotor); and 2) the location of the stable rotor is close to the focal source.: Background: ... ...

    Abstract Objectives: This study was to test the hypotheses that: 1) when using phase analysis, repetitive Wannabe re-entry produces a phase singularity point (i.e., a rotor); and 2) the location of the stable rotor is close to the focal source.
    Background: Recent contact mapping studies in patients with persistent atrial fibrillation (AF) demonstrated that phase analysis produced a different mechanistic result than classical activation sequence analysis. Our studies in patients with persistent AF showed that focal sources sometimes produced repetitive Wannabe re-entry, that is, incomplete re-entry.
    Methods: During open heart surgery, we recorded activation from both atria simultaneously using 510 to 512 electrodes in 12 patients with persistent AF. We performed activation sequence mapping and phase analyses on 4 s of mapped data. For each detected stable rotor (>2 full rotations [720°] recurring at the same site), the corresponding activation patterns were examined from the activation sequence maps.
    Results: During AF, phase singularity points (rotors) were identified in both atria in all patients. However, stable phase singularity points were only present in 6 of 12 patients. The range of stable phase singularity points per patient was 0 to 6 (total 14). Stable phase singularity points were produced due to repetitive Wannabe re-entry generated from a focal source or by passive activation. A conduction block sometimes created a stable phase singularity point (n = 2). The average distance between a focal source and a stable rotor was 0.9 ± 0.3 cm.
    Conclusions: Repetitive Wannabe re-entry generated stable rotors adjacent to a focal source. No true re-entry occurred.
    MeSH term(s) Atrial Fibrillation ; Electrodes ; Heart Atria ; Heart Block ; Humans ; Recurrence
    Language English
    Publishing date 2021-02-24
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2846739-5
    ISSN 2405-5018 ; 2405-500X ; 2405-500X
    ISSN (online) 2405-5018 ; 2405-500X
    ISSN 2405-500X
    DOI 10.1016/j.jacep.2020.12.010
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  8. Book ; Online: Detection of periodic signals in AGN red noise light curves

    Krishnan, S. / Markowitz, A. G. / Schwarzenberg-Czerny, A. / Middleton, M. J.

    empirical tests on the Auto-Correlation Function and Phase Dispersion Minimization

    2021  

    Abstract: Active galactic nucleus (AGN) emission is dominated by stochastic, aperiodic variability which overwhelms any periodic/quasi-periodic signal (QPO) if one is present. The Auto Correlation Function (ACF) and Phase Dispersion Minimization (PDM) techniques ... ...

    Abstract Active galactic nucleus (AGN) emission is dominated by stochastic, aperiodic variability which overwhelms any periodic/quasi-periodic signal (QPO) if one is present. The Auto Correlation Function (ACF) and Phase Dispersion Minimization (PDM) techniques have been used previously to claim detections of QPOs in AGN light curves. In this paper we perform Monte Carlo simulations to empirically test QPO detection feasibility in the presence of red noise. Given the community's access to large databases of monitoring light curves via large-area monitoring programmes, our goal is to provide guidance to those searching for QPOs via data trawls. We simulate evenly-sampled pure red noise light curves to estimate false alarm probabilities; false positives in both tools tend to occur towards timescales longer than (very roughly) one-third of the light curve duration. We simulate QPOs mixed with pure red noise and determine the true-positive detection sensitivity; in both tools, it depends strongly on the relative strength of the QPO against the red noise and on the steepness of the red noise PSD slope. We find that extremely large values of peak QPO power relative to red noise (typically $\sim 10^{4-5}$) are needed for a 99.7 per cent true-positive detection rate. Given that the true-positive detections using the ACF or PDM are generally rare to obtain, we conclude that period searches based on the ACF or PDM must be treated with extreme caution when the data quality is not good. We consider the feasibility of QPO detection in the context of highly-inclined, periodically self-lensing supermassive black hole binaries.

    Comment: 21 pages, 14 figures, Published in MNRAS
    Keywords Astrophysics - High Energy Astrophysical Phenomena
    Subject code 612
    Publishing date 2021-10-27
    Publishing country us
    Document type Book ; Online
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  9. Article ; Online: Does routine preoperative computed tomography imaging provide clinical utility in patients undergoing primary cardiac surgery?

    Merlo, Aurelie / Chen, Kevin / Deo, Salil / Markowitz, Alan

    Interactive cardiovascular and thoracic surgery

    2017  Volume 25, Issue 4, Page(s) 659–662

    Abstract: A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was, in patients undergoing primary cardiac surgery, does routine preoperative computed tomography (CT) imaging provide clinical benefit as ... ...

    Abstract A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was, in patients undergoing primary cardiac surgery, does routine preoperative computed tomography (CT) imaging provide clinical benefit as measured by either a decrease in complications or a change in surgical approach. Altogether, 125 papers were found using the reported search, of which 5 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. All 5 studies reviewed reported change in operative strategy as a result of preoperative imaging, with the most common change being an alternative cannulation site. Two comparative studies reported decreased mortality and decreased perioperative stroke in patients who undergo preoperative CT, when compared to patients who do not. However, the results from these 2 studies are difficult to interpret as they used different imaging modalities and different patient populations. One study selected high-risk patients for preoperative CT, rather than routine use, but the findings were similar. We conclude that preoperative CT, whether non-contrast CT or CT angiography, can help optimize operative strategy and decrease postoperative stroke rate and mortality after primary cardiac surgery.
    Language English
    Publishing date 2017-10-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 2095298-3
    ISSN 1569-9285 ; 1569-9293
    ISSN (online) 1569-9285
    ISSN 1569-9293
    DOI 10.1093/icvts/ivx098
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    Zs.A 5730: Show issues Location:
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  10. Article ; Online: Non-neoplastic inflammatory pseudotumor of the lung after immunotherapy for melanoma: A diagnostic pitfall on fine needle aspiration biopsy of lung.

    Nelson, Blessie Elizabeth / Hong, Angelina / Okereke, Ike / Markowitz, Avi / Willis, Maurice / Muthukumarana, Palawinnage V / Nawgiri, Ranjana

    Diagnostic cytopathology

    2021  Volume 49, Issue 10, Page(s) 1150–1154

    Abstract: Nivolumab is commonly used as monotherapy or in combination therapy for management of locally advanced or metastatic melanoma; however, it is also associated with immunotherapy-related adverse events concerning for disease progression or tumor flare ... ...

    Abstract Nivolumab is commonly used as monotherapy or in combination therapy for management of locally advanced or metastatic melanoma; however, it is also associated with immunotherapy-related adverse events concerning for disease progression or tumor flare reaction. This report presents a case of a non-neoplastic pseudotumor of the lung initially mistaken for malignancy that occurred in a patient receiving adjuvant nivolumab therapy following complete resection of stage IIIB melanoma. The diagnosis was made by lung biopsy and confirmed by a wedge resection, with findings consistent with organizing pneumonia type of pulmonary inflammatory pseudotumor rather than malignancy.
    MeSH term(s) Biopsy, Fine-Needle ; Humans ; Immunotherapy/adverse effects ; Inflammation/pathology ; Lung/diagnostic imaging ; Lung/pathology ; Male ; Melanoma/diagnostic imaging ; Melanoma/therapy ; Middle Aged ; Nivolumab/adverse effects ; Tomography, X-Ray Computed
    Chemical Substances Nivolumab (31YO63LBSN)
    Language English
    Publishing date 2021-07-31
    Publishing country United States
    Document type Case Reports ; Letter
    ZDB-ID 632710-2
    ISSN 1097-0339 ; 8755-1039
    ISSN (online) 1097-0339
    ISSN 8755-1039
    DOI 10.1002/dc.24846
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