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  1. Article ; Online: 15-year survivorship of a unique dual-modular femoral stem in primary hip arthroplasty.

    Scott, David F / Eppich, Kade / Mehić, Edin / Gray, Celeste / Smith, Crystal Lederhos / Johnston, Michael

    BMC musculoskeletal disorders

    2024  Volume 25, Issue 1, Page(s) 312

    Abstract: Background: Hip offset, version, and length are interdependent femoral variables which determine stability and leg length. Balancing these competing variables remains a core challenge in hip arthroplasty. The potential benefits of modular femoral stems ... ...

    Abstract Background: Hip offset, version, and length are interdependent femoral variables which determine stability and leg length. Balancing these competing variables remains a core challenge in hip arthroplasty. The potential benefits of modular femoral stems have been overshadowed by higher rates of failure. The objective of this study was to assess the survivorship of a unique dual-modular femoral stem at an average 15-year follow-up period.
    Methods: The records of all patients with osteoarthritis who underwent primary total hip arthroplasty with this device between 2004-2009 were reviewed. There were no exclusions for BMI or other factors. We examined the data with Kaplan-Meier survival analysis. The primary endpoint for survival was mechanical failure of the modular neck-body junction.
    Results: The survivorship of this device in 172 subjects was 100% with none experiencing mechanical failure of the modular junction at an average of 15 years. 60 patients died of causes unrelated to their THA and 9 patients were lost to follow-up. There were three early (≤ 12 months) dislocations (1.7%), and seven total dislocations (4.1%). 16 patients underwent reoperations during the follow-up period, none for any complication of the modular junction. Radiographic results showed well-fixed femoral stems in all cases. There were no leg length discrepancies of greater than 10 mm, and 85% were within 5 mm.
    Conclusion: There were no mechanical failures of the modular junction in any of the subjects over the average 15-year period, demonstrating that this dual-modular design is not associated with increased failure rates. We achieved a 1.7% early dislocation rate and a 4.1% total dislocation rate without any clinically significant leg length discrepancies.
    MeSH term(s) Humans ; Arthroplasty, Replacement, Hip/instrumentation ; Arthroplasty, Replacement, Hip/adverse effects ; Arthroplasty, Replacement, Hip/methods ; Female ; Male ; Hip Prosthesis ; Middle Aged ; Aged ; Prosthesis Design ; Prosthesis Failure ; Adult ; Follow-Up Studies ; Osteoarthritis, Hip/surgery ; Retrospective Studies ; Aged, 80 and over ; Kaplan-Meier Estimate ; Reoperation/statistics & numerical data ; Femur/surgery ; Femur/diagnostic imaging ; Time Factors
    Language English
    Publishing date 2024-04-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 2041355-5
    ISSN 1471-2474 ; 1471-2474
    ISSN (online) 1471-2474
    ISSN 1471-2474
    DOI 10.1186/s12891-024-07422-0
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  2. Article ; Online: Fast Doppler as a novel bedside measure of cerebral perfusion in preterm infants.

    Peeples, Eric S / Mehic, Edin / Mourad, Pierre D / Juul, Sandra E

    Pediatric research

    2016  Volume 79, Issue 2, Page(s) 333–338

    Abstract: Background: Altered cerebral perfusion from impaired autoregulation may contribute to the morbidity and mortality associated with premature birth. We hypothesized that fast Doppler imaging could provide a reproducible bedside estimation of cerebral ... ...

    Abstract Background: Altered cerebral perfusion from impaired autoregulation may contribute to the morbidity and mortality associated with premature birth. We hypothesized that fast Doppler imaging could provide a reproducible bedside estimation of cerebral perfusion and autoregulation in preterm infants.
    Methods: This is a prospective pilot study using fast Doppler ultrasound to assess blood flow velocity in the basal ganglia of 19 subjects born at 26-32 wk gestation. Intraclass correlation provided a measure of test-retest reliability, and linear regression of cerebral blood flow velocity and heart rate or blood pressure allowed for estimations of autoregulatory ability.
    Results: The intraclass correlation when imaging in the first 48 h of life was 0.634. We found significant and independent correlations between the systolic blood flow velocity and both systolic blood pressure and heart rate (P = 0.015 and 0.012 respectively) only in the 26-28 wk gestational age infants in the first 48 h of life.
    Conclusion: Our results suggest that fast Doppler provides reliable bedside measurements of cerebral blood flow velocity at the tissue level in premature infants, acting as a proxy for cerebral tissue perfusion. Additionally, autoregulation appears to be impaired in the extremely preterm infants, even within a normal range of blood pressures.
    MeSH term(s) Blood Flow Velocity ; Blood Pressure ; Cerebrovascular Circulation ; Gestational Age ; Heart Rate ; Homeostasis ; Humans ; Infant, Extremely Premature ; Infant, Newborn ; Linear Models ; Pilot Projects ; Point-of-Care Testing ; Predictive Value of Tests ; Prospective Studies ; Reproducibility of Results ; Ultrasonography, Doppler, Color ; Ultrasonography, Doppler, Transcranial
    Language English
    Publishing date 2016-02
    Publishing country United States
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 4411-8
    ISSN 1530-0447 ; 0031-3998
    ISSN (online) 1530-0447
    ISSN 0031-3998
    DOI 10.1038/pr.2015.227
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    Zs.A 564: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  3. Article ; Online: Toward Deep Brain Monitoring with Superficial EEG Sensors Plus Neuromodulatory Focused Ultrasound.

    Darvas, Felix / Mehić, Edin / Caler, Connor J / Ojemann, Jeff G / Mourad, Pierre D

    Ultrasound in medicine & biology

    2016  Volume 42, Issue 8, Page(s) 1834–1847

    Abstract: Noninvasive recordings of electrophysiological activity have limited anatomic specificity and depth. We hypothesized that spatially tagging a small volume of brain with a unique electroencephalography (EEG) signal induced by pulsed focused ultrasound ... ...

    Abstract Noninvasive recordings of electrophysiological activity have limited anatomic specificity and depth. We hypothesized that spatially tagging a small volume of brain with a unique electroencephalography (EEG) signal induced by pulsed focused ultrasound could overcome those limitations. As a first step toward testing this hypothesis, we applied transcranial ultrasound (2 MHz, 200-ms pulses applied at 1050 Hz for 1 s at a spatial peak temporal average intensity of 1.4 W/cm(2)) to the brains of anesthetized rats while simultaneously recording EEG signals. We observed a significant 1050-Hz electrophysiological signal only when ultrasound was applied to a living brain. Moreover, amplitude demodulation of the EEG signal at 1050 Hz yielded measurement of gamma band (>30 Hz) brain activity consistent with direct measurements of that activity. These results represent preliminary support for use of pulsed focused ultrasound as a spatial tagging mechanism for non-invasive EEG-based mapping of deep brain activity with high spatial resolution.
    MeSH term(s) Animals ; Brain/diagnostic imaging ; Brain/physiopathology ; Brain Mapping/methods ; Electroencephalography/methods ; Models, Animal ; Phantoms, Imaging ; Rats ; Sensitivity and Specificity ; Ultrasonography/methods
    Language English
    Publishing date 2016
    Publishing country England
    Document type Journal Article
    ZDB-ID 186150-5
    ISSN 1879-291X ; 0301-5629
    ISSN (online) 1879-291X
    ISSN 0301-5629
    DOI 10.1016/j.ultrasmedbio.2016.02.020
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    Zs.A 963: Show issues Location:
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  4. Article ; Online: Transcranial vibro-acoustography can detect traumatic brain injury, in-vivo: Preliminary studies.

    Suarez, Martin W / Dever, David D / Gu, Xiaohan / Ray Illian, P / McClintic, Abbi M / Mehic, Edin / Mourad, Pierre D

    Ultrasonics

    2015  Volume 61, Page(s) 151–156

    Abstract: Vibro-acoustography (VA) uses two or more beams of confocal ultrasound to generate local vibrations within their target tissue through induction of a time-dependent radiation force whose frequency equals that of the difference of the applied frequencies. ...

    Abstract Vibro-acoustography (VA) uses two or more beams of confocal ultrasound to generate local vibrations within their target tissue through induction of a time-dependent radiation force whose frequency equals that of the difference of the applied frequencies. While VA has proven effective for assaying the mechanical properties of clinically relevant tissue such as breast lesions and tissue calcifications, its application to brain remains unexplored. Here we investigate the ability of VA to detect acute and focal traumatic brain injury (TBI) in-vivo through the use of transcranially delivered high-frequency (2 MHz) diagnostic focused ultrasound to rat brain capable of generating measurable low-frequency (200-270 kHz) acoustic emissions from outside of the brain. We applied VA to acute sham-control and TBI model rats (sham N=6; TBI N=6) and observed that acoustic emissions, captured away from the site of TBI, had lower amplitudes for TBI as compared to sham-TBI animals. The sensitivity of VA to acute brain damage at frequencies currently transmittable across human skulls, as demonstrated in this preliminary study, supports the possibility that the VA methodology may one day serve as a technique for detecting TBI.
    MeSH term(s) Animals ; Brain Injuries/diagnostic imaging ; Elasticity Imaging Techniques/instrumentation ; Elasticity Imaging Techniques/methods ; Equipment Design ; Male ; Models, Statistical ; Rats ; Rats, Sprague-Dawley ; Transducers
    Language English
    Publishing date 2015-08
    Publishing country Netherlands
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 200839-7
    ISSN 1874-9968 ; 0041-624X
    ISSN (online) 1874-9968
    ISSN 0041-624X
    DOI 10.1016/j.ultras.2015.04.014
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    Zs.B 1133: Show issues Location:
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  5. Article ; Online: Increased anatomical specificity of neuromodulation via modulated focused ultrasound.

    Mehić, Edin / Xu, Julia M / Caler, Connor J / Coulson, Nathaniel K / Moritz, Chet T / Mourad, Pierre D

    PloS one

    2014  Volume 9, Issue 2, Page(s) e86939

    Abstract: Transcranial ultrasound can alter brain function transiently and nondestructively, offering a new tool to study brain function now and inform future therapies. Previous research on neuromodulation implemented pulsed low-frequency (250-700 kHz) ultrasound ...

    Abstract Transcranial ultrasound can alter brain function transiently and nondestructively, offering a new tool to study brain function now and inform future therapies. Previous research on neuromodulation implemented pulsed low-frequency (250-700 kHz) ultrasound with spatial peak temporal average intensities (ISPTA) of 0.1-10 W/cm(2). That work used transducers that either insonified relatively large volumes of mouse brain (several mL) with relatively low-frequency ultrasound and produced bilateral motor responses, or relatively small volumes of brain (on the order of 0.06 mL) with relatively high-frequency ultrasound that produced unilateral motor responses. This study seeks to increase anatomical specificity to neuromodulation with modulated focused ultrasound (mFU). Here, 'modulated' means modifying a focused 2-MHz carrier signal dynamically with a 500-kHz signal as in vibro-acoustography, thereby creating a low-frequency but small volume (approximately 0.015 mL) source of neuromodulation. Application of transcranial mFU to lightly anesthetized mice produced various motor movements with high spatial selectivity (on the order of 1 mm) that scaled with the temporal average ultrasound intensity. Alone, mFU and focused ultrasound (FUS) each induced motor activity, including unilateral motions, though anatomical location and type of motion varied. Future work should include larger animal models to determine the relative efficacy of mFU versus FUS. Other studies should determine the biophysical processes through which they act. Also of interest is exploration of the potential research and clinical applications for targeted, transcranial neuromodulation created by modulated focused ultrasound, especially mFU's ability to produce compact sources of ultrasound at the very low frequencies (10-100s of Hertz) that are commensurate with the natural frequencies of the brain.
    MeSH term(s) Animals ; Brain/anatomy & histology ; Brain/physiology ; Male ; Mice, Inbred C57BL ; Motor Activity/physiology ; Pressure ; Ultrasonics/instrumentation ; Ultrasonics/methods
    Language English
    Publishing date 2014-02-04
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0086939
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  6. Article ; Online: Blast exposure causes early and persistent aberrant phospho- and cleaved-tau expression in a murine model of mild blast-induced traumatic brain injury.

    Huber, Bertrand R / Meabon, James S / Martin, Tobin J / Mourad, Pierre D / Bennett, Raymond / Kraemer, Brian C / Cernak, Ibolja / Petrie, Eric C / Emery, Michael J / Swenson, Erik R / Mayer, Cynthia / Mehic, Edin / Peskind, Elaine R / Cook, David G

    Journal of Alzheimer's disease : JAD

    2013  Volume 37, Issue 2, Page(s) 309–323

    Abstract: Mild traumatic brain injury (mTBI) is considered the 'signature injury' of combat veterans that have served during the wars in Iraq and Afghanistan. This prevalence of mTBI is due in part to the common exposure to high explosive blasts in combat zones. ... ...

    Abstract Mild traumatic brain injury (mTBI) is considered the 'signature injury' of combat veterans that have served during the wars in Iraq and Afghanistan. This prevalence of mTBI is due in part to the common exposure to high explosive blasts in combat zones. In addition to the threats of blunt impact trauma caused by flying objects and the head itself being propelled against objects, the primary blast overpressure (BOP) generated by high explosives is capable of injuring the brain. Compared to other means of causing TBI, the pathophysiology of mild-to-moderate BOP is less well understood. To study the consequences of BOP exposure in mice, we employed a well-established approach using a compressed gas-driven shock tube that recapitulates battlefield-relevant open-field BOP. We found that 24 hours post-blast a single mild BOP provoked elevation of multiple phospho- and cleaved-tau species in neurons, as well as elevating manganese superoxide-dismutase (MnSOD or SOD2) levels, a cellular response to oxidative stress. In hippocampus, aberrant tau species persisted for at least 30 days post-exposure, while SOD2 levels returned to sham control levels. These findings suggest that elevated phospho- and cleaved-tau species may be among the initiating pathologic processes induced by mild blast exposure. These findings may have important implications for efforts to prevent blast-induced insults to the brain from progressing into long-term neurodegenerative disease processes.
    MeSH term(s) Analysis of Variance ; Animals ; Blast Injuries/complications ; Brain/metabolism ; Brain/pathology ; Brain Injuries/etiology ; Brain Injuries/pathology ; Disease Models, Animal ; Exploratory Behavior ; Gene Expression Regulation/physiology ; Mice ; Mice, Inbred C57BL ; Phosphorylation ; Superoxide Dismutase/metabolism ; tau Proteins/metabolism
    Chemical Substances tau Proteins ; Superoxide Dismutase (EC 1.15.1.1) ; superoxide dismutase 2 (EC 1.15.1.1)
    Language English
    Publishing date 2013-08-15
    Publishing country Netherlands
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 1440127-7
    ISSN 1875-8908 ; 1387-2877
    ISSN (online) 1875-8908
    ISSN 1387-2877
    DOI 10.3233/JAD-130182
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    Zs.A 6084: Show issues Location:
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