Publications by authors named "Or D"

Previous abdominal surgery (PAS) increases risk of small bowel obstruction (SBO) due to adhesions, and appendectomy (appy) is an independent risk factor for abdominal adhesion-related complications. Peritoneal inflammation, e.g.

View Article and Find Full Text PDF

Low soil moisture and high vapour pressure deficit (VPD) cause plant water stress and lead to a variety of drought responses, including a reduction in transpiration and photosynthesis. When soils dry below critical soil moisture thresholds, ecosystems transition from energy to water limitation as stomata close to alleviate water stress. However, the mechanisms behind these thresholds remain poorly defined at the ecosystem scale.

View Article and Find Full Text PDF

The aging US population has altered the epidemiology of traumatic injury, but there are few studies examining changing patterns of traumatic intracranial hemorrhage (tICH). We examined temporal changes in incidence, demographics, severity, management, and outcomes of tICH among trauma admissions at six US Level I trauma centers over 6 years (July 1, 2016-June 30, 2022). Patients with tICH (subdural, epidural, subarachnoid, and intracerebral hemorrhage) were identified by 10th revision of the International Statistical Classification of Diseases diagnosis codes.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to create a predictive tool to determine which patients with mild traumatic brain injury (mTBI) and subdural hematoma (SDH) may need neurosurgical intervention, as current methods are unreliable and lead to unnecessary treatments.
  • Conducted across six trauma centers, the research analyzed 1,333 patients admitted between 2016 and 2020, using variables like hematoma thickness and Glasgow Coma Scale scores to inform predictions.
  • Results showed a neurosurgical intervention rate of 8.8%, with key factors identified for predicting surgical need while maintaining a sensitivity of 100%.
View Article and Find Full Text PDF

Commonly comprised of cyanobacteria, algae, bacteria and fungi, hypolithic communities inhabit the underside of cobblestones and pebbles in diverse desert biomes. Notwithstanding their abundance and widespread geographic distribution and their growth in the driest regions on Earth, the source of water supporting these communities remains puzzling. Adding to the puzzle is the presence of cyanobacteria that require liquid water for net photosynthesis.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to identify risk factors for immediate neurosurgical intervention in patients with mild traumatic brain injuries and isolated subdural hematomas, using data from 6 trauma centers over a 5-year period.
  • Out of 1333 patients, 117 (8.8%) required surgery within 48 hours, with significant predictors being demographic factors like sex and mechanism of injury, as well as radiographic details like hemorrhage thickness and midline shift.
  • Ultimately, the combined analysis highlighted that advanced directives, Injury Severity Score, midline shift, and maximum hemorrhage thickness were crucial indicators for determining the need for surgical intervention shortly after hospital admission.
View Article and Find Full Text PDF

Introduction: The surgical approach of hemiarthroplasty for displaced femoral neck fractures remains debated. The study objective was to compare in-hospital outcomes for geriatric displaced femoral neck fractures treated with hemiarthroplasty based on surgical approach (direct lateral vs. posterior approach).

View Article and Find Full Text PDF

Introduction: Aneurysmal subarachnoid hemorrhage (aSAH) patients are given calcium channel blockers (CCBs) to prevent brain vessel vasospasm. We hypothesized that preinjury antihypertensive use may protect against vasospasm. It remains unclear whether the timing of in-hospital CCB initiation affects the vasospasm risk in this population.

View Article and Find Full Text PDF

Background: Limited research has explored the effect of Circle of Willis (CoW) anatomy among blunt cerebrovascular injuries (BCVI) on outcomes. It remains unclear if current BCVI screening and scanning practices are sufficient in identification of concomitant COW anomalies and how they affect outcomes.

Methods: This retrospective cohort study included adult traumatic BCVIs at 17 level I-IV trauma centers (08/01/2017-07/31/2021).

View Article and Find Full Text PDF

Background: There is an epidemic of firearm injuries in the United States since the mid-2000s. Thus, we sought to examine whether hospitalization from firearm injuries have increased over time, and to examine temporal changes in patient demographics, firearm injury intent, and injury severity.

Methods: This was a multicenter, retrospective, observational cohort study of patients hospitalized with a traumatic injury to six US level I trauma centers between 1/1/2016 and 6/30/2022.

View Article and Find Full Text PDF

Background: Stress ulcers in patients with traumatic brain injury (TBI) and spinal cord injury (SCI) present significant morbidity and mortality risks. Despite the low reported stress ulcer rates, stress ulcer prophylaxis (SUP) is widely administered in neurocritical care. It was hypothesized that universal SUP administration may not be associated with reduced rates of complications across all neurocritical care patients.

View Article and Find Full Text PDF

Objective: The perioperative management of patients on antiplatelet drugs is a rising challenge in orthopedic trauma because antiplatelet drugs are frequently encountered and carry an increased risk of hemorrhagic consequences. The study objective was to examine the effect of aspirin on bleeding outcomes for patients with lower extremity fractures.

Methods: This retrospective study included patients requiring surgical fixation of traumatic hip, femur, and tibia fractures from January 1, 2018, to March 1, 2020.

View Article and Find Full Text PDF

Objective: There are no studies to date that examine the association between anti-factor-Xa (AFXa)-based heparin monitoring and clinical outcomes in the setting of cerebral venous thrombosis (CVT).

Methods: This pilot study included adults aged ≥18 admitted with CVT between 1 January 2018 and 1 January 2021, who were treated with unfractionated heparin (UFH) and were monitored via AFXa-based nomogram within 24 h of arrival. Comparisons were made between patients with AFXa levels within the target therapeutic range (0.

View Article and Find Full Text PDF

Myoendothelial junctions (MEJs) are structures that allow chemical signals to be transmitted between endothelial cells (ECs) and vascular smooth muscle cells, which control vascular tone. MEJs contain hemoglobin alpha (Hbα) and endothelial nitric oxide synthase (eNOS) complexes that appear to control the production and scavenging of nitric oxide (NO) along with the activity of cytochrome b5 reductase 3 (CYB5R3). The aim of this study was to examine how hypoxia affected the regulation of proteins involved in the production of NO in brain ECs.

View Article and Find Full Text PDF

Introduction: Controversary exists around the best surgical management for traumatic geriatric displaced femoral neck fractures. The study objective was to compare outcomes among those managed with a total hip arthroplasty (THA) to those managed with a hemiarthroplasty (HA).

Methods: This retrospective matched cohort study included geriatric hip fractures (≥65 y/o) admitted 7/1/16-3/31/20.

View Article and Find Full Text PDF
Article Synopsis
  • SARS-CoV-2 causes a range of COVID-19 disease severities, influenced by immune responses that are affected by variants like Omicron.
  • * The protein C1 esterase inhibitor (C1-INH), which regulates the immune system, is found at higher levels in severe COVID-19 cases and may paradoxically worsen the disease.
  • * This review discusses C1-INH’s role in immune response and explores current clinical trials testing exogenous C1-INH treatment for COVID-19.
View Article and Find Full Text PDF

Study Design: National Trauma Data Bank (NTDB) review and propensity-matched analysis.

Objective: To evaluate differences in clinical outcomes by operative management.

Summary Of Background Data: Odontoid type II fractures are the most prevalent cervical fracture.

View Article and Find Full Text PDF

Unlabelled: Restrictive fluid management (RFM) for hemodynamically unstable trauma patients has reduced mortality rates. The objective was to determine whether RFM benefits geriatric hip fracture patients, who are usually hemodynamically stable.

Design: Retrospective propensity-matched study.

View Article and Find Full Text PDF

Background: Reversal of direct oral anticoagulants (DOACs) is currently recommended prior to emergent surgery, such as surgical intervention for traumatic geriatric hip fractures. However, reversal methods are expensive and timely, often delaying surgical intervention, which is a predictor of outcomes. The study objective was to examine the effect of DOAC reversal on blood loss and transfusions among geriatric patients with hip fractures.

View Article and Find Full Text PDF
Article Synopsis
  • The study analyzed C2 fractures (axis fractures) to understand when surgical intervention is necessary, focusing on the differences based on fracture type and patient factors.
  • Out of 38,080 patients, 13.9% underwent surgery, with varying rates based on fracture type: 17.5% for odontoid type II, 11.0% for type I/III, and 11.2% for non-odontoid fractures.
  • Key factors influencing the likelihood of surgery included younger age, treatment at a level I trauma center, and specific fracture characteristics, with different determinants identified for each fracture type.
View Article and Find Full Text PDF

Collateral circulation is important for cerebral perfusion in acute ischemic strokes. Monitoring the oxidation-reduction potential (ORP) may be useful to assess collateral status or treatment efficacy. The objectives of the present study were to determine if the ORP was associated with collateral circulation status in middle cerebral artery (MCA) occlusions and to identify patterns in the ORP and the collateral circulation status among patients treated with intraarterial therapy (IAT) over time.

View Article and Find Full Text PDF

Metabolic causes such as altered bioenergetics and amino acid metabolism may play a major role in Long COVID. Renal-metabolic regulation is an integral part of these pathways but has not been systematically or routinely investigated in Long COVID. Here we discuss the biochemistry of renal tubular injury as it may contribute to Long COVID symptoms.

View Article and Find Full Text PDF

Earth's diverse soil microbiomes host bacteria within dynamic and fragmented aqueous habitats that occupy complex pore spaces and restrict the spatial range of ecological interactions. Yet, the spatial distributions of bacterial cells in soil communities remain underexplored. Here, we propose a modelling framework representing submillimeter-scale distributions of soil bacteria based on physical constraints supported by individual-based model results and direct observations.

View Article and Find Full Text PDF

There have been large changes over the past several decades to patient demographics in those presenting with mild traumatic brain injury (mTBI) with intracranial hemorrhage (ICH; complicated mTBI) with the potential to affect the use of neurosurgical interventions. The objective of this study was to characterize long-term trends of neurosurgical interventions in patients with complicated mTBI using 13 years of the National Trauma Data Bank (NTDB). This was a retrospective cohort study of adult (≥18 years) trauma patients included in the NTDB from 2007 to 2019 who had an emergency department Glasgow Coma Scale score 13-15, an intracranial hemorrhage (ICH), and no skull fracture.

View Article and Find Full Text PDF

The objective of this study was to quantify nation-wide interhospital variation in neurosurgical intervention risk by intracranial hemorrhage (ICH) type in the setting of mild traumatic brain injury (mTBI). This was a retrospective cohort study of adult (≥18 years) trauma patients included in the National Trauma Data Bank from 2007 to 2019 with an emergency department Glasgow Coma Scale score 13-15, diagnosed ICH, no skull fracture. The primary outcome was neurosurgical intervention.

View Article and Find Full Text PDF