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  • 1
    Online Resource
    Online Resource
    Secretory phospholipase A2 in SARS-CoV-2 infection and multisystem inflammatory syndrome in children (MIS-C)
    SAGE Publications ; 2021
    In:  Experimental Biology and Medicine Vol. 246, No. 23 ( 2021-12), p. 2543-2552
    Details
    In: Experimental Biology and Medicine, SAGE Publications, Vol. 246, No. 23 ( 2021-12), p. 2543-2552
    Abstract: Secretory phospholipase 2 (sPLA2) acts as a mediator between proximal and distal events of the inflammatory cascade. Its role in SARS-CoV-2 infection is unknown, but could contribute to COVID-19 inflammasome activation and cellular damage. We present the first report of plasma sPLA2 levels in adults and children with COVID-19 compared with controls. Currently asymptomatic adults with a history of recent COVID-19 infection (≥4 weeks before) identified by SARS-CoV-2 IgG antibodies had sPLA2 levels similar to those who were seronegative (9 ± 6 vs.17 ± 28 ng/mL, P = 0.26). In contrast, children hospitalized with severe COVID-19 had significantly elevated sPLA2 compared with those with mild or asymptomatic SARS-CoV-2 infection (269 ± 137 vs. 2 ± 3 ng/mL, P = 0.01). Among children hospitalized with multisystem inflammatory syndrome in children (MIS-C), all had severe disease requiring pediatric intensive care unit (PICU) admission. sPLA2 levels were significantly higher in those with acute illness 〈 10 days versus convalescent disease ≥10 days (540 ± 510 vs. 2 ± 1, P = 0.04). Thus, sPLA2 levels correlated with COVID-19 severity and acute MIS-C in children, implicating a role in inflammasome activation and disease pathogenesis. sPLA2 may be a useful biomarker to stratify risk and guide patient management for children with acute COVID-19 and MIS-C. Therapeutic compounds targeting sPLA2 and inflammasome activation warrant consideration.
    Type of Medium: Online Resource
    ISSN: 1535-3702 , 1535-3699
    URL: Article
    DOI: 10.1177/15353702211028560
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2020856-X
    SSG: 12
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  • 2
    Online Resource
    Online Resource
    Osteopontin as a biomarker for COVID-19 severity and multisystem inflammatory syndrome in children: A pilot study
    SAGE Publications ; 2022
    In:  Experimental Biology and Medicine Vol. 247, No. 2 ( 2022-01), p. 145-151
    Details
    In: Experimental Biology and Medicine, SAGE Publications, Vol. 247, No. 2 ( 2022-01), p. 145-151
    Abstract: This study sought to evaluate the candidacy of plasma osteopontin (OPN) as a biomarker of COVID-19 severity and multisystem inflammatory condition in children (MIS-C) in children. A retrospective analysis of 26 children (0–21 years of age) admitted to Children’s Healthcare of Atlanta with a diagnosis of COVID-19 between March 17 and May 26, 2020 was undertaken. The patients were classified into three categories based on COVID-19 severity levels: asymptomatic or minimally symptomatic (control population, admitted for other non-COVID-19 conditions), mild/moderate, and severe COVID-19. A fourth category of children met the Centers for Disease Control and Prevention's case definition for MIS-C. Residual blood samples were analyzed for OPN, a marker of inflammation using commercial ELISA kits (R & D), and results were correlated with clinical data. This study demonstrates that OPN levels are significantly elevated in children hospitalized with moderate and severe COVID-19 and MIS-C compared to OPN levels in mild/asymptomatic children. Further, OPN differentiated among clinical levels of severity in COVID-19, while other inflammatory markers including maximum erythrocyte sedimentation rate, C-reactive protein and ferritin, minimum lymphocyte and platelet counts, soluble interleukin-2R, and interleukin-6 did not. We conclude OPN is a potential biomarker of COVID-19 severity and MIS-C in children that may have future clinical utility. The specificity and positive predictive value of this marker for COVID-19 and MIS-C are areas for future larger prospective research studies.
    Type of Medium: Online Resource
    ISSN: 1535-3702 , 1535-3699
    URL: Article
    DOI: 10.1177/15353702211046835
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2020856-X
    SSG: 12
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  • 3
    Online Resource
    Online Resource
    Early Operative Versus Delayed Operative Versus Nonoperative Treatment of Pediatric and Adolescent Anterior Cruciate Ligament Injuries: A Systematic Review and Meta-analysis
    SAGE Publications ; 2021
    In:  The American Journal of Sports Medicine Vol. 49, No. 14 ( 2021-12), p. 4008-4017
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 49, No. 14 ( 2021-12), p. 4008-4017
    Abstract: Treatment options for pediatric and adolescent anterior cruciate ligament (ACL) injuries include early operative, delayed operative, and nonoperative management. Currently, there is a lack of consensus regarding the optimal treatment for these injuries. Purpose/Hypothesis: The purpose was to determine the optimal treatment strategy for ACL injuries in pediatric and adolescent patients. We hypothesized that (1) early ACL reconstruction results in fewer meniscal tears than delayed reconstruction but yields no difference in knee stability and (2) when compared with nonoperative management, any operative management results in fewer meniscal tears and cartilage injuries, greater knee stability, and higher return-to-sport rates. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: A systematic search of databases was performed including PubMed, Embase, and Cochrane Library using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Inclusion criteria were a pediatric and adolescent patient population (≤19 years old at surgery), the reporting of clinical outcomes after treatment of primary ACL injury, and original scientific research article. Exclusion criteria were revision ACL reconstruction, tibial spine avulsion fracture, case report or small case series ( 〈 5 patients), non–English language manuscripts, multiligamentous injuries, and nonclinical studies. Results: A total of 30 studies containing 50 cohorts and representing 1176 patients met our criteria. With respect to nonoperative treatment, knee instability was observed in 20% to 100%, and return to preinjury level of sports ranged from 6% to 50% at final follow-up. Regarding operative treatment, meta-analysis results favored early ACL reconstruction over delayed reconstruction ( 〉 12 weeks) for the presence of any meniscal tear (odds ratio, 0.23; P = .006) and irreparable meniscal tear (odds ratio, 0.31; P = .001). Comparison of any side-to-side differences in KT-1000 arthrometer testing did not favor early or delayed ACL reconstruction in either continuous mean differences ( P = .413) or proportion with difference ≥3 mm ( P = .181). Return to preinjury level of competition rates for early and delayed ACL reconstruction ranged from 57% to 100%. Conclusion: Delaying ACL reconstruction in pediatric or adolescent patients for 〉 12 weeks significantly increased the risk of meniscal injuries and irreparable meniscal tears; however, early and delayed operative treatment achieved satisfactory knee stability. Nonoperative management resulted in high rates of residual knee instability, increased risk of meniscal tears, and comparatively low rates of return to sports.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546521990817
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2063945-4
    SSG: 31
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  • 4
    Online Resource
    Online Resource
    Relationship between brachial artery flow-mediated dilatation, hyperemic shear stress, and the metabolic syndrome
    SAGE Publications ; 2008
    In:  Vascular Medicine Vol. 13, No. 4 ( 2008-11), p. 263-270
    Details
    In: Vascular Medicine, SAGE Publications, Vol. 13, No. 4 ( 2008-11), p. 263-270
    Abstract: Abstract Metabolic syndrome (MetSyn) may predispose to cardiovascular disease (CVD) by causing vascular dysfunction. This study aimed to determine the association of MetSyn with vascular function, as assessed by brachial artery flow-mediated dilatation (FMD) and hyperemic shear stress (HSS). A total of 1,417 male firefighters without established diabetes and CVD were classified for MetSyn, according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP) definition. MetSyn was present in 267 individuals (19%). Although FMD was lower in those with versus without MetSyn (8.1 ± 4.1 vs 8.7 ± 4.0%; p = 0.02), this was not significant after adjusting for baseline differences (age, smoking, and brachial artery diameter) ( p = 0.2). However, HSS was significantly lower in those with versus without MetSyn (72.0 ± 27.8 vs 80.9 ± 24.8 dyne/cm 2 ; p  〈  0.001), and there was a significant inverse graded relationship with the number of NCEP criteria present (mean HSS for those with 0, 1, 2, 3, 4, and 5 criteria: 83.2 ± 22.5, 82.2 ± 24.7, 76.5 ± 27.2, 74.3 ± 27.4, 66.5 ± 28.4, 67.1 ± 27.6 dyne/cm 2 ; p  〈  0.001 for trend). The individual NCEP criteria of abdominal obesity, systolic hypertension, and impaired fasting glucose were independent predictors for HSS. In conclusion, MetSyn was not associated with impaired FMD. Alternatively, HSS, a measure of microvascular function, was significantly lower in those with MetSyn. Thus, MetSyn may contribute to CVD by causing microvascular dysfunction.
    Type of Medium: Online Resource
    ISSN: 1358-863X , 1477-0377
    URL: Article
    DOI: 10.1177/1358863X08095154
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2008
    detail.hit.zdb_id: 2027562-6
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  • 5
    Online Resource
    Online Resource
    A Meta-Analysis of the Clinical and Fusion Results following Treatment of Symptomatic Cervical Pseudarthrosis
    SAGE Publications ; 2015
    In:  Global Spine Journal Vol. 5, No. 2 ( 2015-04), p. 148-155
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 5, No. 2 ( 2015-04), p. 148-155
    Abstract: Systematic literature review and meta-analysis. Objective This study is a meta-analysis assessing the fusion rate and the clinical outcomes of cervical pseudarthrosis treated with either a posterior or a revision anterior approach. Methods A literature search of PubMed, Cochrane, and Embase was performed. Variables of interest included fusion rate and clinical success. The effect size based on logit event rate was calculated from the pooled results. The studies were weighted by the inverse of the variance, which included both within- and between-study error. The confidence intervals were reported at 95%. Heterogeneity was assessed using the Q statistic and I 2 , where I 2 is the estimate of the percentage of error due to between-study variation. Results Sixteen studies reported fusion outcomes; 10 studies reported anterior and/or posterior results. The pooled fusion success was 86.4% in the anterior group and 97.1% in the posterior group ( p = 0.028). The anterior group demonstrated significant heterogeneity with Q value of 34.2 and I 2 value of 73.7%; no heterogeneity was seen in the posterior group. The clinical outcomes were reported in 10 studies, with eight reporting results of anterior and posterior approaches. The pooled clinical success rate was 77.0% for anterior and 71.7% for posterior ( p = 0.55) approaches. There was significant heterogeneity in both groups ( I 2 16.1; 19.2). Conclusions Symptomatic cervical pseudarthrosis can be effectively managed with either an anterior or a posterior approach. The posterior approach demonstrates a significantly greater fusion rate compared with the anterior approach, though the clinical outcome does not differ between the two groups.
    Type of Medium: Online Resource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1055/s-0035-1544176
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
    detail.hit.zdb_id: 2648287-3
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  • 6
    Online Resource
    Online Resource
    Open versus Minimally Invasive Fixation Techniques for Thoracolumbar Trauma: A Meta-Analysis
    SAGE Publications ; 2016
    In:  Global Spine Journal Vol. 6, No. 2 ( 2016-03), p. 186-194
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 6, No. 2 ( 2016-03), p. 186-194
    Abstract: Systematic literature review and meta-analysis of studies published in English. Objective This study evaluated differences in outcome variables between percutaneous and open pedicle screws for traumatic thoracolumbar fractures. Methods A systematic review of PubMed, Cochrane, and Embase was performed. The variables of interest included postoperative visual analog scale (VAS) pain score, kyphosis angle, and vertebral body height, as well as intraoperative blood loss and operative time. The results were pooled by calculating the effect size based on the standardized difference in means. The studies were weighted by the inverse of the variance, which included both within- and between-study error. Confidence intervals were reported at 95%. Heterogeneity was assessed using the Q statistic and I 2 . Results After two-reviewer assessment, 38 studies were eliminated. Six studies were found to meet inclusion criteria and were included in the meta-analysis. The combined effect size was found to be in favor of percutaneous fixation for blood loss and operative time ( p  〈  0.05); however, there were no differences in vertebral body height (VBH), kyphosis angle, or VAS scores between open and percutaneous fixation. All of the studies demonstrated relative homogeneity, with I 2   〈  25. Conclusions Patients with thoracolumbar fractures can be effectively managed with percutaneous or open pedicle screw placement. There are no differences in VBH, kyphosis angle, or VAS between the two groups. Blood loss and operative time were decreased in the percutaneous group, which may represent a potential benefit, particularly in the polytraumatized patient. All variables in this study demonstrated near-perfect homogeneity, and the effect is likely close to the true effect.
    Type of Medium: Online Resource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1055/s-0035-1554777
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
    detail.hit.zdb_id: 2648287-3
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