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1.  Lateral Lumbar Interbody Fusion for the Correction of Spondylolisthesis and Adult Degenerative Scoliosis in High-Risk Patients: Early Radiographic Results and Complications 
The Ochsner Journal  2014;14(1):23-31.
Lateral lumbar interbody fusion (LLIF) is not associated with many of the complications seen in other interbody fusion techniques. This study used computed tomography (CT) scans, the radiographic gold standard, to assess interbody fusion rates achieved utilizing the LLIF technique in high-risk patients.
We performed a retrospective review of patients who underwent LLIF between January 2008 and July 2013. Forty-nine patients underwent nonstaged or staged LLIF on 119 levels with posterior correction and augmentation. Per protocol, patients received CT scans at their 1-year follow-up. Of the 49 patients, 21 patients with LLIF intervention on 54 levels met inclusion criteria. Two board-certified musculoskeletal radiologists and the senior surgeon (JZ) assessed fusion.
Of the 21 patients, 6 patients had had previous lumbar surgery, and the cohort's comorbidities included osteoporosis, diabetes, obesity, and smoking, among others. Postoperative complications occurred in 12 (57.1%) patients and included anterior thigh pain and weakness in 6 patients, all of which resolved by 6 months. Two cases of proximal junctional kyphosis occurred, along with 1 case of hardware pullout. Two cases of abdominal atonia occurred. By CT scan assessment, each radiologist found fusion was achieved in 53 of 54 levels (98%). The radiologists' findings were in agreement with the senior surgeon.
Several studies have evaluated LLIF fusion and reported fusion rates between 88%-96%. Our results demonstrate high fusion rates using this technique, despite multiple comorbidities in the patient population. Spanning the ring apophysis with large LLIF cages along with supplemental posterior pedicle screw augmentation can enhance stability of the fusion segment and increase fusion rates.
PMCID: PMC3963047  PMID: 24688329
Comorbidity; lumbar vertebrae; spinal fusion; surgical procedures–minimally invasive; tomography–x-ray computed
2.  Finger bone immaturity and 2D:4D ratio measurement error in the assessment of the hyperandrogenic hypothesis for the etiology of autism spectrum disorders 
Physiology & behavior  2010;100(3):221-224.
Emerging hypotheses suggest a causal role for prenatal androgen exposure in some cases of autism spectrum disorders (ASD). The ratios of the lengths of the bones of the 2nd to the 4th digit (2D:4D) are purported to be markers for prenatal androgen exposure and to be established early in gestation. Elongation of the 4th digit in response to testosterone is said to reduce 2D:4D in males versus females. We examined the ratios of bones from the left hand radiographs of 75 boys and 6 girls 4–8 years of age, diagnosed with ASD, to evaluate digit ratio as a marker for gestational androgen exposure. Contrary to our expectations, girls had reduced 2D:4D compared to boys but the difference was not significant (Cohen’s D 0.51–0.66, P>0.05). The limited sample size for this study and the absence of a referent group precluded providing robust estimates for girls and identifying possible statistical differences between the sexes. Tanner-Whitehouse 3 (TW3) rating of finger bone growth suggested relative immaturity of the 4th relative to the 2nd digits. Positive correlations were detected for 2D:4D ratios, body mass index (r=0.23, P=0.039), chronologic age (r=0.35, P=0.001), and skeletal age (r=0.42, P<0.0001). The TW3 ratings and associations between 2D:4D ratios and indicators of growth suggest that digits develop at different rates. This asynchronous development may produce differences in 2D:4D over time which could lead to erroneous interpretation of androgen exposure in utero among young ASD children.
PMCID: PMC2897171  PMID: 20093135
Autism spectrum disorder; digit ratio; hyperandrogenic hypothesis; measurement error
3.  Birth and Fetal Death Records and Environmental Exposures: Promising Data Elements for Environmental Public Health Tracking of Reproductive Outcomes 
Public Health Reports  2009;124(6):825-830.
We inventoried and reviewed the birth and fetal death certificates of all 50 U.S. states to identify nonstandard data items that are environmentally relevant, inexpensive to collect, and might enhance environmental public health tracking.
We obtained online or requested by mail or telephone the birth certificate and fetal death record forms or formats from each state. Every state data element was compared to the 2003 standards promulgated by the National Center for Health Statistics to identify any items that are not included on the standard. We then evaluated these items for their utility in environmentally related analyses.
We found three data fields of potential interest. First, although every state included residence of mother at time of delivery on the birth certificate, only four states collected information on how long the mother had lived there. This item may be useful in that it could be used to assess and reduce misclassification of environmental exposures among women during pregnancy. Second, we found that father's address was listed on the birth certificates of eight states. This data field may be useful for defining paternal environmental exposures, especially in cases where the parents do not live together. Third, parental occupation was listed on the birth certificates of 15 states and may be useful for defining parental workplace exposures. Our findings were similar for fetal death records.
If these data elements are accurate and well-reported, their addition to birth, fetal death, and other health records may aid in environmental public health tracking.
PMCID: PMC2773946  PMID: 19894425
4.  Change in Colony Morphology of Candida lusitaniae in Association with Development of Amphotericin B Resistance 
It is not uncommon to see amphotericin B treatment failure in patients with systemic infection caused by Candida lusitaniae. We report a patient with stage IV ovarian carcinoma and C. lusitaniae sepsis whose treatment with amphotericin B failed. The initial blood isolate was susceptible to amphotericin B in vitro; however, the MIC for a blood isolate recovered 7 weeks after treatment began showed a fourfold increase. Direct subculture of two positive blood samples obtained within a week of the patient's death showed the coexistence of two distinct colony color variants on CHROMagar Candida (CAC). One variant was susceptible to amphotericin B, and one was resistant. These results emphasize the importance of repeat amphotericin B susceptibility testing for patients with persistent C. lusitaniae infection. The presence of colony variants on CAC may signal the emergence of amphotericin B resistance in C. lusitaniae and should be investigated.
PMCID: PMC127144  PMID: 11959563

Results 1-4 (4)