Kingclemmensen4803

Progeny were examined for ethanol- and stress-related behaviors in adulthood. Ethanol EV-donors imparted reduced body weight at weaning and modestly increased limited access ethanol intake to male offspring. Ethanol-EV donors also imparted increased basal anxiety-like behavior and reduced sensitivity to ethanol-induced anxiolysis to female offspring. Although Ethanol EV-donor treatment did not recapitulate the ethanol- or stress-related intergenerational effects of paternal ethanol following natural mating, these results demonstrate that coincubation of sperm with epididymal EV preparations is sufficient to impart intergenerational effects of ethanol through the male germline. This mechanism may generalize to the intergenerational effects of a wide variety of paternal preconception perturbations.Background context Spinopelvic parameters indicative of sagittal imbalance include a pelvic tilt (PT) greater than 20° and a mismatch between pelvic incidence (PI) and lumbar lordosis (LL) greater than 10°. However, unlike in fusion surgery, the relationship between spinopelvic parameters and patient reported outcome measurements (PROMs) in patients undergoing lumbar decompression surgery for neurologic symptoms is less clear. Purpose To determine whether PROMs are affected by the amount of residual (postoperative) PI-LL mismatch or PT in patients undergoing one- to three-level lumbar decompression surgeries DESIGN Retrospective cohort study (Level of Evidence III) PATIENT SAMPLE Patients undergoing between one to three levels of lumbar decompression surgery at a single, academic institution. Outcome measures PROMs-including the PCS-12, MCS-12, ODI, and VAS Back and Leg pain scores-and radiographic measurements of spinopelvic parameters. Methods Patients were separated into groups based on a postoperative PI-LL mismatch of ≤ 10° or > 10° and a postoperative PT 10° and PT ≥ 20° without instability had similar PROMs at 1-year after limited lumbar decompression when compared to patients without a spinopelvic mismatch.Background context The patient acceptable symptom state (PASS) has emerged as a novel tool for interpreting patient-reported outcomes. While the minimal clinically important difference (MCID) values for various spine outcome instruments have been defined, little is known about the PASS thresholds for these measures. Purpose To define threshold values on the Neck Disability Index (NDI) corresponding to a PASS in patients undergoing surgery for degenerative disorders of the cervical spine. CGP-57148B Study design Retrospective review of prospectively collected registry data PATIENT SAMPLE The sample includes 613 patients who underwent anterior cervical discectomy and fusion for degenerative spine conditions between 2005 and 2014. Outcome measures The main outcome measure was the Neck Disability Index (NDI). The PASS anchor question was adapted from the NASS questionnaire, "How would you rate the overall results of your treatment?" and the validation question was adapted from the AAOS cervical spine questionnaire, "Would y80, sensitivity 86%, specificity 65%). Sensitivity analyses revealed that the 17-point threshold on the NDI was robust. PASS responders were approximately 12 times more likely to be satisfied (adjusted OR 12.11, 95% CI 6.96-21.07) and 6 times more willing to undergo surgery again (adjusted OR 6.12, 95% CI 3.47-10.80) compared to non-responders. Conclusions Patients with a NDI of ≤17 consider their postoperative symptom state to be acceptable. This PASS threshold can be used alongside the MCID when defining treatment success in spine outcomes studies. At the individual level, this threshold provides clinically relevant benchmarks for surgeons when assessing a patient's postoperative recovery.Background context Lumbar fusion has shown to be an effective surgical management option when indicated, improving patient outcomes and functional status. However, concerns of adjacent segment pathology (ASP) due to reduced mobility at the operated segment have fostered the emergence of motion-preserving procedures (MPP). Purpose To assess rates of radiographic adjacent segment degeneration (ASDeg) and symptomatic adjacent segment disease (ASDis) as well as reoperation rates due to ASP in patients who have undergone lumbar fusion compared to motion-preservation for degenerative disorders. Study design Systematic Review and Meta-Analysis METHODS Following PRISMA guidelines, a systematic review and meta-analysis was conducted to find current (1/2012-12/2019) retrospective cohort studies and randomized controlled trials evaluating rates of ASDeg, ASDis, and reoperations due to lumbar ASP. Results A total of 1,751 patients (791 underwent fusion surgery and 960 motion-preserving procedures) in 19 publications wereired to evaluate the long-term consequences of these procedures on patient-reported outcomes, postoperative complications, and associated inpatient/outpatient costs.Background context Lumbar laminectomy and discectomy surgeries are among the most common procedures performed in the US, and often take place at academic teaching hospitals, involving the care of resident physicians. While academic institutions are critical for the maturation of the next generation of attending surgeons, concerns have been raised regarding the quality of resident-involved care. There is conflicting evidence regarding the effects of resident participation in teaching hospitals on spine surgery patient outcomes. As the volume of lumbar laminectomy and discectomy increases, it is imperative to determine how academic status impacts clinical and economic outcomes. Purpose The purpose of this study is to determine if lumbar laminectomy and discectomy surgeries for degenerative spine diseases performed at academic teaching centers is associated with more adverse clinical outcomes and increased cost compared to those performed at nonacademic centers. Study design/setting This study is a multi-center 1 year (OR0.84, 95% CI 0.77-0.91, p less then 0.001) post index procedure. There was no difference in 30- and 90-day all-cause readmission, or discharge disposition between the two groups. Conclusion Elective lumbar laminectomy and discectomy for degenerative lumbar conditions at teaching hospitals is associated with higher costs, but decreased length of stay and no difference in readmission rates at 30- and 90-days post-operatively compared to non-teaching hospitals. Teaching hospitals had a decreased risk of return to the operating room at 30 days, 90 days and 1 year post-operatively. Our findings might serve as an impetus for other states or regions to compare outcomes at teaching and non-teaching sites.