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  • 1
    Online Resource
    Online Resource
    Concha Bullosa Affects Baseline and Postoperative Quality-of-Life Measures in Surgically Managed Chronic Rhinosinusitis
    SAGE Publications ; 2020
    In:  American Journal of Rhinology & Allergy Vol. 34, No. 2 ( 2020-03), p. 162-169
    Details
    In: American Journal of Rhinology & Allergy, SAGE Publications, Vol. 34, No. 2 ( 2020-03), p. 162-169
    Abstract: Concha bullosa (CB) is a prevalent anatomic variant and frequent surgical target in endoscopic sinus surgery (ESS). However, whether CB impacts quality-of-life (QOL) in chronic rhinosinusitis (CRS) is not well established. The purpose of this study was to investigate baseline and post-ESS QOL differences in patients with medically recalcitrant CRS with and without CB. Methods Demographic and surgical characteristics, baseline and postoperative 22-item Sino-Nasal Outcome Test (SNOT-22) scores for 137 patients with CRS who underwent primary ESS at our institution were recorded. Computed tomography (CT) scans were reviewed for Lund–Mackay score and presence of CB. Multiplanar CT was used to measure CB dimensions and estimate volume. Multivariable analysis was performed to identify differences in SNOT-22 overall and symptom-domain scores between patients with upper quartile (≥0.8 mL) CB and without CB. Results CB was found in 37% of patients with mean volume of 0.67 mL. There were no significant differences in distribution of clinicodemographic variables by large CB status. At baseline, large CB was associated with higher SNOT-22 extranasal-rhinologic domain score (9.8 vs 6.0, P  〈  .01). Following ESS, patients with large CB reported greater improvement in SNOT-22 extranasal-rhinologic domain score (multivariable mean absolute improvement 3.8, P = .01; relative 56% vs 30%). Conclusion Patients with medically recalcitrant CRS and concomitant large CB have higher SNOT-22 extranasal-rhinologic domain scores at baseline, but also report greater intradomain improvement exceeding the subdomain’s mean clinically important difference. To our knowledge, this is the first demonstration that CB has a clinically significant impact on QOL in CRS, and surgical intervention may be helpful to address these symptoms.
    Type of Medium: Online Resource
    ISSN: 1945-8924 , 1945-8932
    URL: Article
    DOI: 10.1177/1945892419881836
    RVK:
    XA 20278
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2554548-6
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  • 2
    Online Resource
    Online Resource
    Estimating the sample mean and standard deviation from commonly reported quantiles in meta-analysis
    SAGE Publications ; 2020
    In:  Statistical Methods in Medical Research Vol. 29, No. 9 ( 2020-09), p. 2520-2537
    Details
    In: Statistical Methods in Medical Research, SAGE Publications, Vol. 29, No. 9 ( 2020-09), p. 2520-2537
    Abstract: Researchers increasingly use meta-analysis to synthesize the results of several studies in order to estimate a common effect. When the outcome variable is continuous, standard meta-analytic approaches assume that the primary studies report the sample mean and standard deviation of the outcome. However, when the outcome is skewed, authors sometimes summarize the data by reporting the sample median and one or both of (i) the minimum and maximum values and (ii) the first and third quartiles, but do not report the mean or standard deviation. To include these studies in meta-analysis, several methods have been developed to estimate the sample mean and standard deviation from the reported summary data. A major limitation of these widely used methods is that they assume that the outcome distribution is normal, which is unlikely to be tenable for studies reporting medians. We propose two novel approaches to estimate the sample mean and standard deviation when data are suspected to be non-normal. Our simulation results and empirical assessments show that the proposed methods often perform better than the existing methods when applied to non-normal data.
    Type of Medium: Online Resource
    ISSN: 0962-2802 , 1477-0334
    URL: Article
    DOI: 10.1177/0962280219889080
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2001539-2
    detail.hit.zdb_id: 1136948-6
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  • 3
    Online Resource
    Online Resource
    Outcomes Following Anterior Cervical Discectomy and Fusion in Patients With Ehlers-Danlos Syndrome
    SAGE Publications ; 2023
    In:  Global Spine Journal
    Details
    In: Global Spine Journal, SAGE Publications
    Abstract: Retrospective database analysis. Objectives To study postoperative complication rates following anterior cervical discectomy and fusion (ACDF) in patients with Ehlers-Danlos syndrome (EDS) compared with patients without EDS. Methods The Mariner database was utilized to identify patients with EDS undergoing one or two level anterior cervical discectomy and fusion (ACDF). Postoperative short-term outcomes assessed included medical complications, readmissions, and ED-visits within 90 days of surgery. Additionally, surgical complications including wound complications, surgical site infection, one- and two-year anterior revision along with posterior revision, pseudarthrosis, and hardware failure within 2 years were assessed. Multivariate logistic regression was used to adjust for demographic variables, comorbidities and number of levels operated on. Results The present study identified 533 patients in the EDS group and 2634 patients in the matched control group. EDS patients undergoing ACDF are at an increased risk for 90-day major medical complications (OR 3.31; P 〈 .001). EDS patients were also found to be associated with surgical complications including wound complications (OR 2.94; P 〈 .001), surgical site infection (OR 8.60; P 〈 .001) within 90 days, pseudarthrosis (OR 2.33; P 〈 .001), instrument failure (OR 4.03; P 〈 .001), anterior revision (OR 22.87; P 〈 .001), and posterior revision (OR 3.17; P 〈 .001) within 2 years. Conclusions EDS is associated with higher rates of both medical and surgical complications following ACDF. Spine surgeons should be cognizant of the increased risks in this population to provide appropriate preoperative counseling and enhanced perioperative medical management.
    Type of Medium: Online Resource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1177/21925682231151924
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2648287-3
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  • 4
    Online Resource
    Online Resource
    Follow-Up Adherence Is Associated with Outcomes After Endoscopic Sinus Surgery
    SAGE Publications ; 2020
    In:  Annals of Otology, Rhinology & Laryngology Vol. 129, No. 7 ( 2020-07), p. 707-714
    Details
    In: Annals of Otology, Rhinology & Laryngology, SAGE Publications, Vol. 129, No. 7 ( 2020-07), p. 707-714
    Abstract: Clinical follow-up after endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) allows for assessment of the sinonasal cavity, debridement, and tailoring of medical therapies. Frequency and timing of postoperative clinical visits is debated, but the impact of adherence on disease-specific outcomes is not well understood. In this longitudinal study, we assessed the association between follow-up adherence and quality of life (QOL) outcomes in the 12 months after ESS. Methods: A retrospective review of patients undergoing ambulatory ESS for CRS between 11/2016 and 1/2018 was performed. We assessed sociodemographic characteristics, radiographic severity, and QOL utilizing the 22-item sinonasal outcome test (SNOT-22). Patients were categorized as “non-adherent,” “moderately-adherent,” and “fully-adherent” to a 1-, 3- and 5-week postoperative visit schedule. Results: A total of 166 patients met the inclusion criteria. Of these, 55 (33.1%) were fully-adherent, 105 (63.2%) were moderately-adherent, and 6 (3.6%) were non-adherent within the 6 weeks following ESS. In the immediate postoperative period, fully-adherent patients demonstrated worse QOL (SNOT-22: 31.2 ± 23.1 vs 27.5 ± 17.6, P = .047). This cohort also had greater psychological dysfunction at baseline and 12-months ( P  〈  .05) after ESS. Extra-nasal symptom scores increased at a lower rate in the fully-adherent cohort (0.12 vs 1.29 points per 6 months, P = .038), as did ear/facial symptoms (1.17 vs 3.05 points per 6 months, P = .044). Conclusion: Despite worse symptom severity in the immediate postoperative period, patients who are more adherent to the follow-up schedule demonstrated slower return of symptoms in the extra-rhinological and ear-facial domains. These findings suggest that clinical adherence and management may impact the long-term evolution of ESS outcomes.
    Type of Medium: Online Resource
    ISSN: 0003-4894 , 1943-572X
    URL: Article
    DOI: 10.1177/0003489420908291
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2033055-8
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  • 5
    Online Resource
    Online Resource
    Metagenomic identification of a novel oomycete cultured from a pyogranulomatous mass on the tail of a domestic cat
    SAGE Publications ; 2023
    In:  Journal of Veterinary Diagnostic Investigation Vol. 35, No. 5 ( 2023-09), p. 507-513
    Details
    In: Journal of Veterinary Diagnostic Investigation, SAGE Publications, Vol. 35, No. 5 ( 2023-09), p. 507-513
    Abstract: We report here a transiently culturable oomycete pathogen isolated from a pyogranulomatous tail mass in a cat. The organism was morphologically and genetically distinct from Lagenidium and Pythium species. Following next-generation sequencing (NGS) and assembly of contigs, initial phylogenetic analysis using fragments of the cox1 mitochondrial gene identified this specimen as Paralagenidium sp. after nucleotide alignments with sequences obtained from the Barcode of Life Data System (BOLD). However, further analysis of a concatenation of 13 different mitochondrial genes showed that this organism is unique and different from all known oomycetes. A negative PCR result using primers targeting known oomycete pathogens may not be enough to rule out oomycosis in a suspected case. Additionally, the use of a single gene to classify oomycetes may produce misleading results. The advent of metagenomic sequencing and NGS provides a unique opportunity to further explore the diversity of oomycetes as plant and animal pathogens beyond the current capabilities of global barcoding projects that are based on partial genomic sequences.
    Type of Medium: Online Resource
    ISSN: 1040-6387 , 1943-4936
    URL: Article
    DOI: 10.1177/10406387231180310
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2265211-5
    SSG: 22
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