A5021837352- Reproductive System and Pregnancy
- Reconstructive Surgery and Microvascular Techniques
- Head and Neck Cancer Studies
- Pregnancy and preeclampsia studies
- Tracheal and airway disorders
- Cardiac, Anesthesia and Surgical Outcomes
- Airway Management and Intubation Techniques
- Voice and Speech Disorders
- Preterm Birth and Chorioamnionitis
- Anesthesia and Pain Management
- Trauma Management and Diagnosis
- Hip and Femur Fractures
- Dysphagia Assessment and Management
- Family Support in Illness
- Immune Cell Function and Interaction
- Nerve Injury and Rehabilitation
- Pregnancy and Medication Impact
- Oral and Maxillofacial Pathology
- Cancer survivorship and care
- Head and Neck Surgical Oncology
- Cancer and Skin Lesions
- Thyroid and Parathyroid Surgery
- Prenatal Screening and Diagnostics
- IgG4-Related and Inflammatory Diseases
- Oral Health Pathology and Treatment
Nebraska Methodist College
2015-2024
Methodist Hospital
2015-2024
Houston Methodist
2015-2024
Creighton University
2011-2024
Karolinska Institutet
2023
Pioneer (United States)
2023
Linköping University
2015-2021
Nebraska Medical Center
2016
Guangzhou Medical University
2016
University of Nebraska Medical Center
2012-2015
A successful pregnancy requires that the maternal immune system is instructed to a state of tolerance avoid rejection semiallogeneic fetal-placental unit. Although increasing evidence supports decidual (uterine) macrophages and regulatory T cells (Tregs) are key regulators fetal tolerance, it not known how these tolerogenic leukocytes induced. In this article, we show human placenta itself, mainly through trophoblast cells, able induce homeostatic M2 Tregs. Placental-derived M-CSF IL-10...
Genome amplification and cellular senescence are commonly associated with pathological processes. While physiological roles for polyploidization have been described in mouse development, controversy exists over their significance humans. Here, we describe tetraploidization as phenomena of normal human placenta development. During pregnancy, placental extravillous trophoblasts (EVTs) invade the pregnant endometrium, termed decidua, to establish an adapted microenvironment required developing...
Prescription opioid use contributes to drug-related adverse effects and risk for dependence abuse. Multimodal analgesia (MMA) has been shown be useful in reducing following orthopedic, gynecologic, colorectal surgery, but adoption head neck surgery lagged. Recently, we published findings related the feasibility of MMA protocols same-day thyroid, parathyroid, parotid surgery. However, whether such strategies lead effective durable reduction frequency prescriptions, affect physician...
Is the newly discovered cytokine interleukin (IL)-34 expressed at human fetal–maternal interface in order to influence polarization of monocytes into macrophages a decidual immunoregulatory phenotype? IL-34 was found be present interface, both fetal placenta and maternal decidua, it able polarize phenotype. shown bind same receptor as macrophage-colony stimulating factor (M-CSF), which has an important immunomodulatory role for example by polarizing M2-like regulatory is known regulate...
<h3>Importance</h3> Perioperative analgesia strategies that rely solely on narcotics may contribute to adverse effects and concerns about opioid abuse or dependence. Multimodal protocols incorporating nonnarcotic agents reduce the need for postoperative narcotic use. <h3>Objective</h3> To evaluate feasibility safety of a multimodal protocol outpatient head neck surgical procedures identify association with pain perception scores patient satisfaction. <h3>Design, Setting, Participants</h3>...
Objective preoperative risk assessment tools, such as the Modified Frailty Index (mFI), may inform patient and physician decision making when considering total laryngectomy. Estimation of outcomes help to set realistic expectations about recovery facilitate optimal resource management.To evaluate association between mFI score a measure frailty following laryngectomy.Retrospective evaluation using American College Surgeons National Surgical Quality Improvement Program (ACS NSQIP), risk-...
During pregnancy, the semi-allogeneic nature of foetus requires maternal immune adaption and acquisition tolerance at foetal-maternal interface. Macrophages with regulatory properties T (Treg) cells are central in promoting foetal enriched decidua (the uterine endometrium during pregnancy). Although tissue-resident decidual stromal (DSC) have been implicated functions, it is not known if they able to induce phenotype macrophages T-cells. In this study we report that maternally derived DSC...
Objective Major causes of donor site morbidity after free flap harvest are lack split‐thickness skin graft (STSG) take and tendon exposure. Long‐term cosmesis remains poor. AlloDerm has shown cosmetically better healing, albeit prolonged healing. We sought to evaluate the use STSG with compared alone. Study Design Case series chart review. Setting Academic tertiary care medical center. Methods Subjects Institutional review board–approved study. Microvascular database queried from 2002 2012....
<h3>Objective</h3>To determine the efficacy of free flap reconstruction in patients 90 years and older.<h3>Design</h3>Retrospective medical chart review.<h3>Setting</h3>Academic center.<h3>Patients</h3>Patients older who underwent a from 2002 through 2011 were identified.<h3>Main Outcome Measures</h3>Clinical, demographic, procedural data recorded. Complications surgery either or related. Long-term follow-up was recorded to late complications, donor site morbidity, functional...
Objectives/Hypothesis To study the impact of a non–intensive care unit (ICU)–based postoperative management strategy on patient outcomes following vascularized free tissue transfer for head and neck surgical defects. Study Design Retrospective cohort study. Methods The patients consisted two groups adults who underwent reconstruction between July 2007 June 2012, at an academic community‐based hospital. By protocol, first group had planned admission to intensive unit. After creation...
Abstract Background The superficial branch of the radial nerve is frequently encountered when performing harvest for a forearm free tissue transfer. Methods and Results We present an abnormal course this which has not been described in literature. During flap, we that was deep to brachioradialis muscle proximal arm; rather, found be through its entire course. An in‐depth literature review performed, there no documented abnormality identified resembling encountered. Conclusion Knowledge...
Background Over the last several decades, reconstruction of head and neck oncologic defect has been revolutionized by use microvascular free tissue transfer. The majority these defects can be reconstructed with ability to visually monitor flap, intervene as soon vascular compromise becomes evident. Occasionally, it is necessary a flap that no visual external monitor: buried flap. A belief circulated within community flaps do not well visible flaps. By our review, there are recent data in...
Mucosal-associated invariant T (MAIT) cells are an innate-like cell subset with proinflammatory and cytotoxic effector functions. During pregnancy, modulation of the maternal immune system, both at fetal-maternal interface systemically, is crucial for a successful outcome manifests through controlled enhancement innate dampening adaptive responses. Still, defenses need to efficiently protect mother fetus from infection. So far, it unknown whether MAIT subjected immunomodulation during...
Abstract Objective Assess the impact of tracheostomy on postoperative morbidity and mortality examine factors that predicted in head neck flap patients. Study Design Retrospective cohort January 2017 to December 2021. Setting Single tertiary center. Methods Adult patients undergoing reconstruction were included, excluding cutaneous reconstruction, laryngectomy, or with present at surgery. Patients routinely extubated immediately following Univariate multivariable analyses examined...
Laryngotracheal stenosis (LTS) can cause persistent or recurrent airway obstruction. Although there is extensive literature on surgical techniques to treat LTS at onset, are few described for complex adult after failed prior surgery. We describe a procedure used successfully in 3 patients who required structural augmentation LTS.Patients were treated with staged reconstruction using prefabricated composite graft consisting of auricular cartilage and radial forearm free flap.All underwent...
Objectives To identify differences in postoperative wound complications associated with a primary tracheoesophageal puncture (TEP) at the time of laryngectomy versus no TEP. Study Design Retrospective review large national data set. Setting Academic and nonacademic health care facilities United States, contributing de-identified, risk-adjusted clinical to American College Surgeons National Surgical Quality Improvement Program. Subjects Methods The Program set for years 2006 2012 identified...
Abstract Background This study examines the association of multimodal analgesia (MMA) protocol for head and neck microvascular reconstruction with postoperative safety opioid use. Methods Retrospective, intention‐to‐treat analysis 226 patients undergoing between January 1, 2014 August 30, 2018 at a tertiary‐care hospital following MMA implementation. Multivariable models examined outcomes interest. Results There were no differences groups in frequency bleeding, return to operating room,...
During pregnancy, maternal blood circulates through the intervillous space of placenta and reciprocal interactions between foetal tissues immune cells makes a unique immunological niche. Labour is characterised by proinflammatory response in myometrium, but relationship local systemic changes during onset labour remains elusive. We here aimed to investigate how circulatory systems are affected from an point view. report that proportion monocytes dramatically higher peripheral (PB), (IVB)...
The risk-benefit analysis of any operation is influenced by its perioperative complications. Our objective was to examine the relationship between preoperative clinical characteristics and postoperative respiratory failure (PRF: mechanical ventilation for >48 hours after surgery or reintubation) within 30 days thyroid parathyroid surgeries.American College Surgeons' multicenter, prospective, National Surgical Quality Improvement Program (NSQIP) datasets (2007/2008) were used. Multivariable...
Abstract Problem While there are several known causes for recurrent pregnancy loss (RPL), about 50% unexplained (uRPL), and in these cases, an aberrant immune regulation seems to be involved. Although fetally derived trophoblast cells have a key role regulation, it is difficult study their function during pregnancy, not whether may inherent aberration uRPL or associated with the outcome of current pregnancy. Method Chorionic villus sampling (CVS) was performed clinical indications at 12...
Stomal recurrence in patients after laryngectomy has a poor prognosis. Studies performed using sternal resection with pectoralis flap reconstruction report <25% 2-year survival. The purpose of this study was to ascertain whether the use larger free improves survival.Thirteen cases stomal that underwent extended and were identified classified according Sisson criteria. Postoperative morbidity, mortality, survival assessed.Median 10 months types I II, 37.5% 1-year 25% Median 6 III IV, 40% 0%...