Publications by authors named "Akshitha Adhiyaman"

Article Synopsis
  • This case report discusses a pediatric patient with focal fibrocartilaginous dysplasia (FFCD) who experienced angular deformity and growth arrest, even with standard guided growth management.
  • The patient initially underwent implant-mediated guided growth for correcting a proximal tibia varus deformity, but the issue recurred, leading to the identification of a physeal bar that resulted in complete physeal arrest.
  • The report concludes that while treatment for FFCD-related angular deformity may involve observation and guided growth, there is a significant risk of complete physeal arrest that needs to be considered.
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Background: Recent evidence has identified a strong association between growth hormone therapy and physeal injuries in the lower extremity; however, few studies have investigated this association in the upper extremity.

Questions/purposes: (1) Do pediatric patients with physeal tension injuries of the shoulder and elbow have higher odds of having exposure to recombinant growth hormone therapy than matched controls? (2) Are the odds of having exposure to recombinant growth hormone therapy in physeal tension injuries different when stratified by shoulder and elbow injuries?

Methods: Using a matched case-control study design, patients between 4 and 18 years of age treated at a large, urban, academic center from February 1, 2016, to November 6, 2023, were identified by ICD-10 codes using EPIC SlicerDicer, an electronic medical record-based data mining tool. Patients diagnosed with physeal tension injuries in the shoulder or elbow were included in the case group, and those with midshaft radius, metaphyseal radius, or both-bone forearm fractures were included in the control group.

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Background: Developmental hip dysplasia (DDH) is a common condition associated with pain, disability and early hip osteoarthritis when untreated. Health utility scores have not previously been defined for a comprehensive set of DDH health states. The purpose of this study was to establish utility scores associated with DDH health states.

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Introduction: Early-onset scoliosis (EOS) refers to spinal curvature exceeding ten degrees in the coronal plane in patients under 10 years old. When non-operative management fails to control the curvature, surgical intervention may be indicated. In younger patients, growth-friendly instrumentation may be necessary to allow for continued spinal growth while controlling the curve, which includes magnetically control growing rods (MCGR).

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Historically, pedicle screw accuracy measurements have relied on CT and expert visual assessment of the position of pedicle screws relative to preoperative plans. Proper pedicle screw placement is necessary to avoid complications, cost and morbidity of revision procedures. The aim of this study was to determine accuracy and precision of pedicle screw insertion via a novel computer vision algorithm using preoperative and postoperative computed tomography (CT) scans.

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Article Synopsis
  • The study aimed to investigate how matching participants with their preferred financial incentive designs affected their adherence to behavioral goals in a weight management intervention among individuals with obesity.
  • It involved a secondary analysis of quantitative and qualitative data from 668 participants from socioeconomically disadvantaged communities in New York City and Los Angeles, specifically examining the reasons behind their preferred incentive types.
  • Results indicated that a majority preferred goal-directed incentives, and those who were matched with their preference showed higher adherence rates in certain areas, suggesting that preference alignment might enhance engagement in some program activities.
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Study Design: Retrospective case series.

Objective: To characterize the change in angle of trunk rotation (ATR), axial vertebral rotation (AVR), and body surface rotation (BSR) in patients with adolescent idiopathic scoliosis (AIS) undergoing posterior spinal fusion (PSF) with en-bloc derotation across multiple postoperative visits.

Summary Of Background Data: Previous research has documented ATR, AVR, and BSR correction for AIS patients after surgery.

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Article Synopsis
  • Pelvic fixation is utilized in pediatric patients with neuromuscular scoliosis and adult patients with lumbosacral issues to correct pelvic obliquity and ensure stability.
  • S2-alar-iliac screws are preferred over traditional iliac screws due to their reduced visibility and effectiveness in minimally invasive surgeries.
  • This technical note outlines a robotically navigated technique for placing S2-alar-iliac screws that enhances precision, accommodates irregular anatomy, and minimizes surgical exposure, supported by five successful case studies.
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Objective: Emergency physicians are challenged to efficiently and reliably risk stratify patients presenting with chest pain (CP) to optimize diagnostic testing and avoid unnecessary hospital admissions. The objective of our study was to evaluate the impact of a HEART score-based decision aid (HSDA) integrated in the electronic health record on coronary computed tomography angiography (CCTA) utilization and diagnostic yield in adult emergency department (ED) CP patients with suspected acute coronary syndrome.

Methods: We conducted a before and after study to determine whether implementation of a mandatory computerized HSDA would reduce CCTA utilization in ED CP patients and improve the diagnostic yield of obstructive coronary artery disease (CAD) (≥50%).

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Nonshivering thermogenesis occurs in brown adipose tissue to generate heat in response to cold ambient temperatures. Thioesterase superfamily member 1 (Them1) is transcriptionally up-regulated in brown adipose tissue upon exposure to the cold and suppresses thermogenesis in order to conserve energy reserves. It hydrolyzes long-chain fatty acyl-CoAs that are derived from lipid droplets, preventing their use as fuel for thermogenesis.

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