Publications by authors named "Geller D"

Background: Operative mortality for high-grade liver injury (HGLI) remains 42% to 66%, with near-universal mortality after retrohepatic caval injury. The objective of this study was to evaluate mortality and complications of operative and nonoperative management (OM and NOM) of HGLI at our institution, characterized by a trauma surgery-liver surgery collaborative approach to trauma care.

Methods: This was an observational cohort study of adult patients (age ≥16) with HGLI (The American Association for Surgery of Trauma (AAST) grades IV and V) admitted to an urban level I trauma center from January 2010 to November 2021.

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Objective: Selective serotonin reuptake inhibitors (SSRIs) are the first choice in pharmacotherapy for children and adolescents with obsessive-compulsive disorder (OCD). SSRI-trials for pediatric OCD have never been investigated using individual participant data (IPD), which is crucial for detecting patient-level effect modifiers. Here, we performed an IPD meta-analysis on the efficacy of SSRIs compared to placebo, and a meta-regression on baseline patient characteristics which might modify efficacy.

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Background: The pelvis is one of the most common areas for metastatic bone disease. We recently described the use of a minimally invasive percutaneous screw fixation of metastatic non-periacetabular pelvic lesions, with excellent results.

Description: The procedure can be completed in a standard operating theater without the need for special instruments.

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Introduction: Liver transplantation (LT) provides significant survival benefits to patients with unresectable HCC. In the United States, organ allocation policies for HCCs within the United Network for Organ Sharing criteria do not prioritize patients based on their differences in oncological characteristics. This study assessed whether transplant-associated survival benefits (TASBs) vary among patients with different tumor burden scores (TBS) measured at the time of listing.

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Trends in diagnostic biopsy sample collection approaches for primary bone sarcomas have shifted in the past 2 decades. Although open/incisional biopsies used to be the predominant approach to obtain diagnostic material for Ewing sarcoma and osteosarcoma, image-guided core needle biopsies have increased in frequency and are safe for patients. These procedures are less invasive and reduce recovery times but have potential limitations.

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Background: Liver transplantation stands as the primary treatment for end-stage liver disease, with demand surging in recent decades because of expanded indications. However, hepatic ischemia/reperfusion injury can lead to liver transplant failure in both deceased donor and living donor transplantation. This study explored whether preconditioning donor livers through exercise training (ExT) could mitigate cold ischemic injury posttransplantation.

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Purpose Of Review: Initiation of hemodialysis treatment with a thrice-weekly prescription is currently the standard of care irrespective of patients' residual kidney function (RKF), comorbidities, and preferences.

Recent Findings: Each year ∼12 000 Veterans with advanced kidney disease progress to end-stage kidney disease (ESKD) requiring dialysis and comprise greater than 10% of the US incident ESKD population. Dialysis is costly and is associated with impaired health-related quality of life (HRQOL) and high mortality risk, especially in the first year of treatment.

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Objective: To examine the rates as well as the interdependence of depressive symptoms and sleep problems in patients with cancer and their intimate partner family caregivers.

Method: Patients diagnosed with cancer (69.3 years old, 56.

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Introduction: Hemophilia A (HA) therapy poses a significant healthcare burden. In recent years, emicizumab has been approved for prophylaxis. The current study explores the impact of transitioning to emicizumab on emergency department (ED) visits and hospitalizations in pediatric and adult HA patients.

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  • Molecular studies indicate that ALT is a crucial prognostic marker for shorter relapse-free survival (RFS) in pancreatic neuroendocrine tumors (PanNETs) and other neoplasms.
  • The development of a new chromogenic ALT assay (ALT-CISH) was initiated to address clinical limitations of the traditional fluorescence in situ hybridization (FISH) method, showing a 100% agreement with FISH results in validating that ALT is present in 31% of primary PanNETs.
  • The study demonstrated that ALT status is significantly associated with poorer RFS in both PanNET and leiomyosarcoma (LMS) patients, with ALT being an independent prognostic factor
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  • The study investigates how the length of time taken during liver surgeries affects the likelihood of postoperative complications in patients undergoing different types of liver resections.
  • A total of 5,424 patients were analyzed from multiple centers between 2000 and 2022, focusing on procedures like right hemihepatectomy, technically major resection, and left lateral sectionectomy.
  • Results show that patients in the longest operative time group had a significantly higher risk of complications, particularly in various surgical approaches like open, laparoscopic, and robotic surgeries.
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Background: Exercise can promote sustainable protection against cold and warm liver ischemia-reperfusion injury (IRI) and tumor metastases. We have shown that this protection is by the induction of hepatic mitochondrial biogenesis pathway. In this study, we hypothesize that ZLN005, a PGC-1α activator, can be utilized as an alternative therapeutic strategy.

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Background: Pediatric OCD is associated with functional impairment in multiple environments. However, relatively little is known about the impact of comorbid conditions, as well as OCD severity on psychosocial functioning in this population. Furthermore, most studies did not include a control sample, nor examined differences between children and adolescents.

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  • A study was conducted to compare robotic minor liver resections (RMLR) with laparoscopic minor liver resections (LMLR) in patients undergoing surgery on the anterolateral liver segments.
  • The analysis included over 10,000 patients and employed propensity score matching to balance the groups for accuracy in comparisons.
  • Results indicated RMLR had benefits like less blood loss, lower major morbidity, and shorter hospital stays than LMLR, although the difference in 30-day readmission rates suggested RMLR may have some drawbacks.
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  • The "Tripod Technique" is a surgical method for treating metastatic periacetabular lesions, showing good outcomes but requiring skilled execution due to potential complications.
  • Researchers developed a custom guiding frame using preoperative CT scans and advanced technology like a convolutional neural network to optimize screw placement.
  • In a study with 12 patients, the guiding frame significantly reduced surgery time and improved pain management and functional status post-operation, indicating the technique's effectiveness.
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Synovial sarcoma (SS) is an aggressive soft tissue sarcoma with poor prognosis due to late recurrence and metastasis. Metastasis is an important prognostic factor of SS. This study aimed to identify the core genes and mechanisms associated with SS metastasis.

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  • Metabolic syndrome (MS) is linked to hepatocellular carcinoma (HCC), prompting a study on the long-term outcomes of liver resections in MS patients.
  • Data from 813 patients over 20 years showed a median overall survival of 81.4 months, with a recurrence rate of 48.3%, often peaking at 6 and 24 months post-surgery.
  • The study concluded that while patients have favorable long-term outcomes, the timing and nature of recurrences—linked to tumor features and cirrhosis—play a crucial role in survival, highlighting the need for careful post-operative monitoring.
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  • The study aimed to create global benchmark outcome indicators for laparoscopic right posterior sectionectomies (L-RPS/H67) to improve surgical standards.
  • It analyzed data from 854 patients across 57 centers globally, establishing key performance benchmarks for low-risk cases based on specific outcome indicators.
  • The findings set standard benchmarks for metrics like operation time and complication rates, serving as a reference for surgical auditing and improvement.
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  • Osteosarcoma is the most prevalent bone cancer in children, and new research targets specific molecular pathways to improve treatment outcomes through enhanced apoptosis and reduced tumor inflammation.
  • Using single-cell RNA sequencing, researchers found that a transgenic mouse model effectively mirrors the tumor characteristics and microenvironment seen in human osteosarcoma, highlighting the importance of specific gene knockouts in reducing T cell exhaustion and promoting interferon activation.
  • The study suggests mechanisms of tumor escape from treatment, such as gene overexpression and alternative pathways, providing insights that could lead to the development of innovative therapies for osteosarcoma.
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  • The study investigates the risk factors and outcomes related to open conversion during minimally invasive liver resections (MILR), especially in minor hepatectomies, highlighting its association with inferior results.
  • Analysis was conducted on data from over 10,500 patients who underwent laparoscopic or robotic liver resections from 2004 to 2020, identifying key independent predictors for open conversion.
  • Results show that patients who required open conversion experienced longer recovery times, increased blood loss, higher complications, and elevated 90-day mortality rates compared to those who had successful minimally invasive surgeries.
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Background: This study sought to identify associations between the Yost Index, a geocoded area neighborhood socioeconomic status (nSES) score, and race/ethnicity with patient refusal of recommended surgery for metastatic bone disease.

Methods: Patients with metastatic bone disease were extracted from the Surveillance, Epidemiology, and End Results database. The Yost Index was geocoded using factor analysis and categorized into quintiles using census tract-level American Community Service (ACS) 5-year estimates and seven nSES measures.

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  • The objective was to create the first consensus guidelines for the safety and use of robotics in Hepato-Pancreatic-Biliary (HPB) surgery, while also identifying areas for future research.
  • A multidisciplinary jury, using the Zurich-Danish model, formulated recommendations based on expert panels' responses to key questions and the best available evidence from 285 studies.
  • The results highlighted the feasibility and value of robotic surgery in HPB operations but stressed the need for proper expertise and training, as well as prospective registries for evaluating outcomes in future trials.*
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