Introduction of an enhanced recovery pathway results in decreased length of stay in patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion: A description of implementation strategies and retrospective before-and-after study of outcomes.

Study Objective: This study assessed whether implementation of an enhanced recovery-based pathway decreased length of stay without increasing readmissions among patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion.

Design: Retrospective observational before-and-after study.

Setting: A tertiary children's hospital.

Pulmonary Implications of Pediatric Spinal Deformities.

"Pediatric spinal deformities may be associated with pulmonary complications in a patient's lifetime. A review of the diagnosis of spinal abnormalities includes classifications of scoliosis and kyphosis, correlating physical examination findings and radiographic interpretation. The natural history of untreated spine deformities is reviewed along with the associated altered pulmonary compromise.

Pediatric Scoliosis and Kyphosis: An Overview of Diagnosis, Management, and Surgical Treatment.

Evaluation of pediatric spinal deformity requires knowledge of special orthopaedic testing and radiographic interpretation. The determination of recommendations for treatment of spinal abnormalities in children can be challenging and at times complex, as treatment options are dependent upon a variety of factors. The etiology of scoliosis or kyphosis, presence or absence of vertebral anomalies, symptoms, magnitude of the curve, physiologic/skeletal age, and evidence of and risk of progression all require consideration and play a role in the shared decision-making process.

Effects of divided attention on swallowing in persons with idiopathic Parkinson's disease.

The purpose of this study was to determine whether attentional resources are involved in swallowing in persons with idiopathic Parkinson's disease, and if so, in which phase(s) of swallowing. The approach involved a dual-task, reaction time (RT) paradigm using ten participants with Parkinson's disease. Single-task baseline measures were obtained for durations of the anticipatory phase and oropharyngeal phase of swallowing and RTs were obtained for nonword auditory stimuli.

Effects of divided attention on swallowing in healthy participants.

Swallowing impairments are treated mostly behaviorally. It is requisite to understand the relationship of cognition, specifically attention, with swallowing since so many swallowing impairments occur concomitantly with cognitive disorders. This study examined the hypothesis that attentional resources are required during swallowing.

Developmental dysplasia of the hip in infants with congenital muscular torticollis.

Infants with congenital muscular torticollis (CMT) are at increased risk for developmental dysplasia of the hip (DDH), which has led to increased use of diagnostic procedures. Our goal in this study was to establish indications for imaging the hips of infants presenting with CMT. We reviewed the cases of 292 patients with the diagnosis of CMT, 16 of whom were found to have DDH.

The impact of listening with directional microphone technology on self-perceived localization disabilities and handicaps.

The chief complaint of individuals with hearing impairment is difficulty hearing in noise, with directional microphones emerging as the most capable remediation. Our purpose was to determine the impact of directional microphones on localization disability and concurrent handicap. Fifty-seven individuals participated unaided and then in groups of 19, using omni-directional microphones, directional-microphones, or toggle-switch equipped amplification.

Validity, internal consistency, and test/retest reliability of a localization disabilities and handicaps questionnaire.

Psychometric evaluations were performed on a self-perceived localization disabilities and handicaps questionnaire. Twenty individuals with normal hearing bilaterally, twenty with profound unilateral hearing impairment (UHI), and ten with any degree of bilateral hearing impairment participated. Each subject completed the questionnaire.

The relationship among voice onset, voice quality, and fundamental frequency: a dynamical perspective.

In dynamical motor theory, skill acquisition occurs as a modification of preexisting coordination patterns or attractor states. The purpose of this study was to assess how different levels of voice onset, voice quality, and fundamental frequency (F(0)) combine to form the attractor states common to voice motor control. Three levels of voice onset (glottal, simultaneous, and breathy), voice quality (modal speech, mixed, and falsetto), and fundamental frequency (low, mid, and high) were manipulated by vocally untrained, female subjects.

Pigment epithelium-derived factor, a human testis epididymis secretory product, promotes human prostate stromal cell growth in culture.

Purpose: We identified and characterized unrecognized testicular secretory proteins that impact human prostate growth.

Materials And Methods: Human spermatocele fluid served as a source of testicular epididymal secretions and prostatectomy specimen benign prostatic hyperplasia stromal cells as the in vitro prostate growth promoting effects indicator. RMPI plus medium supplemented with 10% fetal bovine serum MALDI-TOF, MS FBS and ITS+ (Collaborative Research-Becton Dickinson, Bedford, Massachusetts) served as positive and negative controls, respectively.

Lung volume effects on pharyngeal swallowing physiology.

The experiment was a prospective, repeated-measures design intended to determine how the variation of lung volume affects specific measures of swallowing physiology. Swallows were recorded in 28 healthy subjects, who ranged in age from 21 to 40 yr (mean age of 29 yr), by using simultaneous videofluoroscopy, bipolar intramuscular electromyography, and respiratory inductance plethysmography. Each subject swallowed three standardized pudding-like consistency boluses at three randomized lung volumes: total lung capacity, functional residual capacity, and residual volume.

Incidence and severity of sexual adverse experiences in finasteride and placebo-treated men with benign prostatic hyperplasia.

Objectives: To evaluate the incidence and resolution of sexual adverse experiences (AEs) in men with benign prostatic hyperplasia treated with finasteride 5 mg compared with placebo.

Methods: The Proscar Long-term Efficacy and Safety Study (PLESS) was a 4-year, randomized, double-blind, placebo-controlled trial assessing the efficacy and safety of finasteride 5 mg in 3040 men, aged 45 to 78 years, with symptomatic benign prostatic hyperplasia, enlarged prostates, and no evidence of prostate cancer. Patients completed a questionnaire at screening regarding their history of sexual dysfunction.

Physiologic effects of open and closed tracheostomy tubes on the pharyngeal swallow.

Studies linking aspiration and dysphagia to an open tracheostomy tube exemplify the possibility that the larynx may have an influence on oropharyngeal swallow function. Experiments addressing the effects of tracheostomy tube occlusion during the swallow have looked at the presence and severity of aspiration, but few have included measurements that capture the changes in swallowing physiology. Also, hypotheses for the importance of near-normal subglottic air pressure during the swallow have not been offered to date.

Biochemical disease-free survival following adjuvant and salvage irradiation after radical prostatectomy.

Purpose: To present the biochemical cure rates (biochemically no evidence of disease) after external irradiation (RT) in patients with high-risk prostate cancer after radical prostatectomy.

Methods And Materials: Seventy-six patients who underwent radical prostatectomy and subsequent RT were included in this analysis. No patient received hormonal therapy.

A kyphectomy technique with reduced perioperative morbidity for myelomeningocele kyphosis.

Study Design: The lumbar sacropelvis in 11 patients with myelomeningocele and kyphosis was treated with a subtraction kyphectomy technique and posterior instrumentation. The results of this procedure in the 11 patients were evaluated and compared with previous results.

Objective: To examine critically their experience using the subtraction (decancellation) vertebrectomy technique combined with posterior instrumentation for myelomeningocele kyphosis, the authors reviewed the charts of 18 myelomeningocele patients who underwent surgery for lumbar kyphosis between 1994 and 1998.

The long-term effect of specific type II 5alpha-reductase inhibition with finasteride on bone mineral density in men: results of a 4-year placebo controlled trial.

Purpose: We determine the effect of long-term suppression of dihydrotestosterone with finasteride, a specific type II 5alpha-reductase inhibitor, on bone mineral density.

Materials And Methods: As part of a large (3,040 cases) 4-year, double-blind, placebo controlled trial designed to assess the long-term effects of finasteride in men with benign prostatic hyperplasia, 157 men 46 to 76 years old who were randomized to receive either 5 mg. finasteride or placebo underwent dual energy x-ray absorptiometry of the lumbar spine at baseline and at years 2, 3 and 4.

Standards in anterior spine surgery in pediatric patients with neuromuscular scoliosis.

The authors reviewed 111 patients with neuromuscular disease who underwent anterior spine surgery for correction of scoliosis. An overall complication rate of 44.1% was found, 21.

High fat diet increases the weight of rat ventral prostate.

Background: Understanding the mechanisms by which diet influences the prostate may eventually lead to novel approaches for preventing prostate cancer. The objective of this research is to examine the impact of dietary fat, vitamin D, and genistein on prostate weight, serum and intraprostatic androgen levels, and the expression of several androgen-response genes.

Methods: Sprague-Dawley rats were fed, beginning at 21 days of age, for 1 or 3 months of experimental diets with high saturated fat (32.

The role of knowledge of results in performance and learning of a voice motor task.

The relationship between the provision of Knowledge of Results and the performance and learning of a voice motor task was examined. Thirty adult subjects, randomly assigned to a 100%, 50%, or No Knowledge of Results group, practiced a novel vowel nasalization task. Measures of accuracy and variability obtained during the practice session indicated influence of knowledge of results schedule on the transient effects of motor performance.

Experimental cryptorchidism inhibited growth of the rat ventral prostate.

Adult Sprague-Dawley male rats, weighing about 350 g, were rendered cryptorchid by suturing the testes to the lateral abdominal wall. Twenty-eight days later, cryptorchidism resulted in a significant decline in testis weight and suppressed spermatogenesis. The ventral prostate was significantly smaller in cryptorchid rats.

Growth factors in expressed prostatic fluid from men with prostate cancer, BPH, and clinically normal prostates.

Background: Although growth factors such as epidermal growth factor (EGF), transforming growth factor (TGF)-alpha, and TGF-beta are important regulators of prostate cell growth in vitro and in animal models, evidence to support their role in human prostate cancer development remains sparse. We previously showed that men without prostate cancer have concentrations of EGF and TGF-alpha in expressed prostatic fluid (EPF) that are individually distinct and stable over time. This study addressed whether growth factor levels in EPF are associated with the presence or progression of prostate cancer.

Long-term outcome of patients with intraspinal neuroblastoma.

Background: Chemotherapy, radiotherapy, and surgical decompression with laminectomy are effective therapeutic options in the treatment of cord compression from neuroblastoma (NB). We report the long-term outcome of patients with intraspinal NB treated with or without laminectomy at two large pediatric oncology centers.

Procedure: We reviewed the medical records and radiographs of 26 children with intraspinal NB treated at Children's Memorial Hospital in Chicago, Illinois, between 1985 and 1994 or at St.

Differential growth rates in stromal cultures of human prostate derived from patients of varying ages.

Background: This study was undertaken to attempt to characterize changes in in vitro growth rates and cellular phenotypes of human prostatic stroma associated with aging and/or development of benign prostatic hyperplasia (BPH).

Methods: Prostate stromal cell strains were established from 12 tissue donors of varying age. Culture growth rate was determined by cell counts over a 6-day period.

Total protein and acid phosphatase concentrations in prostatic fluid from patients with BPH compared to carcinoma.

Objective: To obtain evidence of metabolic changes in the human prostate associated with prostate pathology, in particular carcinoma of the prostate, by identifying and evaluating associated changes in prostatic secretory products.

Methods: Expressed prostatic fluid (EPF) from 36 patients with carcinoma, 128 with BPH histologically confirmed, and 148 with clinical BPH was subjected to determination of protein (Lowry; UV 280 nm absorption), enzymatic (DMA modified Row procedure) acid phosphatase (AcP), and immunologically identified (Tandem-PAP immunoenzymatic assay) prostatic acid phosphatase (PAP) concentration.

Results: The important EPF findings are the following: (1) Protein concentrations (Lowry and UV determinations) are significantly increased in carcinoma as compared to histologic BPH, (2) AcP and PAP secretions remain stable in carcinoma versus BPH, and (3) AcP and PAP/Lowry protein ratios are significantly lower with carcinoma.