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4. The Role of Sleep Apnea in Postoperative Neurocognitive Disorders Among Older Noncardiac Surgery Patients: A Prospective Cohort Study

Author

Devinney, Michael J., Spector, Andrew R., Wright, Mary C., Thomas, Jake, Avasarala, Pallavi, Moretti, Eugene W., Dominguez, Jennifer E., Smith, Patrick J., Whitson, Heather E., Veasey, Sigrid C., Mathew, Joseph P., Berger, Miles, Acker, Leah, Anakwenze, Oke, Anolick, Harel, Attarian, David, Au, Sandra, Ayoub, Chakib, Barber, Matthew, Beach, Rachel, Berchuck, Andrew, Bishara, Katherine, Blazer, Dan, Blennow, Kaj, Bolognesi, Michael, Brassard, Rachele, Brigman, Brian, Browndyke, Jeffrey N., Bullock, William, Bunning, Thomas, Cai, Victor, Cheong, Vanessa, Christensen, Soren, Chung, Stacey, Cohen, Harvey J., Colin, Brian, Cox, Mitchell, D’Amico, Thomas, Davidson, Brittany, Davis, Julia, Deorio, James, Easley, Mark, Eleswarpu, Sarada, Erdmann, Detlev, Feingold, Mariana, Ferrandino, Michael, Gadsden, Jeffrey, Gage, Mark, Ganesh, Arun, Garrigues, Grant, Giattino, Charles, Greenup, Rachel, Habib, Ashraf, Hall, Ashley, Hallows, Rhett, Harpole, David, Hartwig, Matthew, Havrilesky, Laura, Holland, Courtney, Hollenbeck, Scott, Hopkins, Thomas, Houser, Edward, Huang, Samuel, Iboaya, Ehimemen, Inman, Brant, Jiranek, William, Kahmke, Russel, Kawasaki, Amie, Kelleher, Brendan, Kim, Jay, Klapper, Jacob, Klifto, Christopher, Klinger, Rebecca, Knechtle, Stuart, Lagoo-Deenadayalan, Sandhya, Lan, Billy, Lee, Walter, Levinson, Howard, Lewis, Brian, Lipkin, Michael, Mantyh, Christopher, Marlor, Ellie, Martinez-Wilson, Hector, Maxwell, Cory, Migaly, John, Moul, Judd, Murdoch, David, Novick, Thomas, Odom, Kathryn, Ohlendorf, Brian, Olson, Steven, Page, Shannon, Pappas, Theodore, Park, John, Peterson, Andrew, Podgoreanu, Andreea, Polascik, Thomas, Portenier, Dana, Preminger, Glenn, Previs, Rebecca, Rampersaud, Edward, Record, Sydney, Roberts, Kenneth, Robertson, Cary, Roman, Sanziana, Rothman, Jason, Sandler, Aaron, Sata, Siddharth, Scales, Charles, Scheri, Randall, Seyler, Thorsten, Seymour, Keri, Siddiqui, Nazema, Smani, Shayan, Stang, Michael, Stanley, Samuel, Sweeney, Katherine, Syed, Ayesha, Takla, Jeffry, Taormina, Martin, Terrando, Niccolo, Thacker, Julie, Tong, Betty, Toulgoat-Dubois, Yanne, VanDusen, Keith, Waldron, Nathan, Weidner, Alison, Weinhold, Kent, Wellman, Samuel, Williams, David, Wong, Megan K., Yang, Rosa, Young, Christopher, Zani, Sabino, Zetterberg, Henrik, and Zhang, Mimi

Published
2025
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6. Cognitive and Cerebrospinal Fluid Alzheimer’s Disease–related Biomarker Trajectories in Older Surgical Patients and Matched Nonsurgical Controls

Author

Reese, Melody, Wong, Megan K., Cheong, Vanessa, Ha, Christine I., Cooter Wright, Mary, Browndyke, Jeffrey, Moretti, Eugene, Devinney, Michael J., Habib, Ashraf S., Moul, Judd W., Shaw, Leslie M., Waligorska, Teresa, Whitson, Heather E., Cohen, Harvey J., Welsh-Bohmer, Kathleen A., Plassman, Brenda L., Mathew, Joseph P., Berger, Miles, Amundsen, C. L., Bengali, S., Bennett, E., Berry, M. F., Blazer, D. G., Bolognesi, M. P., Brassard, R., Brigman, B. E., Bullock, M., Carter, J., Chapman, J., Colin, B., D’Amico, T. A., DeOrio, J. K., Erdmann, D., Esclamado, R. M., Ferrandino, M., Funk, B., Gadsden, J., Gardner, J., Garrigues, G., Giattino, C., Gold, D. T., Grant, S., Guercio, J., Gupta, D. K., Habib, A., Harpole, D. H., Harris, S. M., Hartwig, M. G., Hollenbeck, S. T., Hu, J., Iboaya, E., Inman, B. A., Jang, D. W., Kaisen, J., Khan, A., Lagoo-Deenadayalan, S., Laskowitz, D. T., Lee, P. S., Lee, W. T., Lemm, J., Levinson, H., Lipkin, M. E., Mantyh, C. R., McDonagh, D. L., Migaly, J., Mithani, S. K., Mosca, P., Moul, J., Newman, M. F., Ni, K., Ohlendorf, B., Onaitis, M. W., Pappas, T. N., Perez, A. N., Peterson, A. C., Polascik, T. J., Podgoreanu, A., Preminger, G. M., Quinones, Q., Rampersaud, E. N., Ray, A., Roberts, K., Robertson, C. N., Roman, S. A., Runyon, S., Sandler, A., Sbahi, F., Scales, C. D., Scheri, R. P., Smith, S. K., Talbot, L., Thacker, J. K. M., Thomas, J., Tong, B. C., Toulgoat-Dubois, Y., Tu, A., Vaslef, S. N., Whittle, J., Woldorff, M., Waldron, N., Warner, D. S., Wang, X., Wellman, S. S., Wickenheisser, T., Young, C., and Zani, S.

Published
2024
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7. Flow cytometry quantification of tumor-infiltrating lymphocytes to predict the survival of patients with diffuse large B-cell lymphoma

Author

Tiantian Yu, Zijun Y. Xu-Monette, Anand Lagoo, Wen Shuai, Bangchen Wang, Jadee Neff, Luis F. Carrillo, Eric D. Carlsen, Sergio Pina-Oviedo, and Ken H. Young

Subjects
tumor-infiltrating lymphocytes, normal B cells, TIL, DLBCL, prognosis, microenvironment, Immunologic diseases. Allergy, RC581-607
Abstract

IntroductionOur previous studies have demonstrated that tumor-infiltrating lymphocytes (TILs), including normal B cells, T cells, and natural killer (NK) cells, in diffuse large B-cell lymphoma (DLBCL) have a significantly favorable impact on the clinical outcomes of patients treated with standard chemoimmunotherapy. In this study, to gain a full overview of the tumor immune microenvironment (TIME), we assembled a flow cytometry cohort of 102 patients diagnosed with DLBCL at the Duke University Medical Center.MethodsWe collected diagnostic flow cytometry data, including the proportion of T cells, abnormal B cells, normal B cells, plasma cells, NK cells, monocytes, and granulocytes in fresh biopsy tissues at clinical presentation, and analyzed the correlations with patient survival and between different cell populations.ResultsWe found that low T cell percentages in all viable cells and low ratios of T cells to abnormal B cells correlated with significantly poorer survival, whereas higher percentages of normal B cells among total B cells (or high ratios of normal B cells to abnormal B cells) and high percentages of NK cells among all viable cells correlated with significantly better survival in patients with DLBCL. After excluding a small number of patients with low T cell percentages, the normal B cell percentage among all B cells, but not T cell percentage among all cells, continued to show a remarkable prognostic effect. Data showed significant positive correlations between T cells and normal B cells, and between granulocytes and monocytes. Furthermore, we constructed a prognostic model based on clinical and flow cytometry factors, which divided the DLBCL cohort into two equal groups with remarkable differences in patient survival and treatment response.SummaryTILs, including normal B cells, T cells, and NK cells, are associated with favorable clinical outcomes in DLBCL, and flow cytometry capable of quantifying the TIME may have additional clinical utility for prognostication.

Published
2024
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10. EEG pre-burst suppression: characterization and inverse association with preoperative cognitive function in older adults

Author

Melody Reese, Soren Christensen, Harel Anolick, Kenneth C. Roberts, Megan K. Wong, Mary Cooter Wright, Leah Acker, Jeffrey N. Browndyke, Marty G. Woldorff, Miles Berger, the MADCO-PC and INTUIT Investigators, O Akinyemi, CL Amundsen, P Avasarala, M Barber, R Beach, S Bengali, E Bennett, A Berchuck, MF Berry, DG Blazer, MP Bolognesi, R Brassard, BE Brigman, JN Browndyke, M Bullock, T Bunning, A Burke, V Cai, J Carter, J Chapman, C Chen, V Cheong, S Christensen, HJ Cohen, B Colin, C Colon-Emeric, M Cooter, M Cox, D Crabtree, B Davidson, JK DeOrio, M Devinney, TA D’Amico, ME Easley, E Ehieli, T Ellett, D Erdmann, RM Esclamado, M Ferrandino, B Funk, J Gadsden, J Gardner, G Garrigues, C Giattino, DT Gold, S Grant, R Greenup, J Guercio, DK Gupta, A Habib, RK Hallows, DH Harpole, SM Harris, MG Hartwig, L Havrilesky, T Henley, C Holland, ST Hollenbeck, J Hu, R Huang, E Iboaya, BA Inman, DW Jang, J Kaisen, A Kawasaki, A Khan, J Klapper, S Lagoo-Deenadayalan, DT Laskowitz, PS Lee, WT Lee, J Lemm, H Levinson, ME Lipkin, H Litchfield, CR Mantyh, E Marlor, KT Martucci, J Mathew, C Maxwell, DL McDonagh, J Migaly, SK Mithani, E Moretti, P Mosca, J Moul, D Murdoch, MF Newman, K Ni, T Novick, B Ohlendorf, S Olson, MW Onaitis, D Oyeyemi, TN Pappas, GL Pellom, AN Perez, AC Peterson, A Podgoreanu, TJ Polascik, P Potash, GM Preminger, R Previs, Q Quinones, EN Rampersaud, A Ray, A Renne, K Roberts, CN Robertson, SA Roman, S Runyon, E Sanders, A Sandler, F Sbahi, CD Scales, RP Scheri, K Seymour, S Smani, SK Smith, M Stang, S Stanley, K Sweeney, A Syed, A Szydlowska, L Talbot, N Terrando, JKM Thacker, J Thomas, BC Tong, Y Toulgoat-Dubois, A Tu, SN Vaslef, N Waldron, X Wang, DS Warner, K Weinhold, SS Wellman, H Whitson, T Wickenheisser, D Williams, M Woldorff, MK Wong, C Young, and S Zani

Subjects
burst suppression, perioperative, anesthesia, non-cardiac surgery, EEG, postoperative delirium, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

The most common complication in older surgical patients is postoperative delirium (POD). POD is associated with preoperative cognitive impairment and longer durations of intraoperative burst suppression (BSup) – electroencephalography (EEG) with repeated periods of suppression (very low-voltage brain activity). However, BSup has modest sensitivity for predicting POD. We hypothesized that a brain state of lowered EEG power immediately precedes BSup, which we have termed “pre-burst suppression” (preBSup). Further, we hypothesized that even patients without BSup experience these preBSup transient reductions in EEG power, and that preBSup (like BSup) would be associated with preoperative cognitive function and delirium risk. Data included 83 32-channel intraoperative EEG recordings of the first hour of surgery from 2 prospective cohort studies of patients ≥age 60 scheduled for ≥2-h non-cardiac, non-neurologic surgery under general anesthesia (maintained with a potent inhaled anesthetic or a propofol infusion). Among patients with BSup, we defined preBSup as the difference in 3–35 Hz power (dB) during the 1-s preceding BSup relative to the average 3–35 Hz power of their intraoperative EEG recording. We then recorded the percentage of time that each patient spent in preBSup, including those without BSup. Next, we characterized the association between percentage of time in preBSup and (1) percentage of time in BSup, (2) preoperative cognitive function, and (3) POD incidence. The percentage of time in preBSup and BSup were correlated (Spearman’s ρ [95% CI]: 0.52 [0.34, 0.66], p < 0.001). The percentage of time in BSup, preBSup, or their combination were each inversely associated with preoperative cognitive function (β [95% CI]: −0.10 [−0.19, −0.01], p = 0.024; −0.04 [−0.06, −0.01], p = 0.009; −0.04 [−0.06, −0.01], p = 0.003, respectively). Consistent with prior literature, BSup was significantly associated with POD (odds ratio [95% CI]: 1.34 [1.01, 1.78], p = 0.043), though this association did not hold for preBSup (odds ratio [95% CI]: 1.04 [0.95, 1.14], p = 0.421). While all patients had ≥1 preBSup instance, only 20.5% of patients had ≥1 BSup instance. These exploratory findings suggest that future studies are warranted to further study the extent to which preBSup, even in the absence of BSup, can identify patients with impaired preoperative cognition and/or POD risk.

Published
2023
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20. Intelligent Collision Avoidance and Manoeuvring System with the Use of Augmented Reality and Artificial Intelligence

Author

Bram-Larbi, K. F., Charissis, V., Khan, S., Lagoo, R., Harrison, D. K., Drikakis, D., Kacprzyk, Janusz, Series Editor, Pal, Nikhil R., Advisory Editor, Bello Perez, Rafael, Advisory Editor, Corchado, Emilio S., Advisory Editor, Hagras, Hani, Advisory Editor, Kóczy, László T., Advisory Editor, Kreinovich, Vladik, Advisory Editor, Lin, Chin-Teng, Advisory Editor, Lu, Jie, Advisory Editor, Melin, Patricia, Advisory Editor, Nedjah, Nadia, Advisory Editor, Nguyen, Ngoc Thanh, Advisory Editor, Wang, Jun, Advisory Editor, and Arai, Kohei, editor

Published
2021
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21. Syphilis D' Emblée: A case series of the great masquerader

Author

Murali Narasimhan, Mayank Lagoo, Ramakrishnan Ramachandran, and Soosai Donald Fernandes

Subjects
syphilis, syphilis d'emblée, vdrl, Medicine
Abstract

Syphilis, a chronic infectious disease caused by Treponema pallidum subspecies pallidum, progresses through three arbitrary stages resulting in varied clinical manifestations. The aberrant presentation of syphilis in the secondary stage without any clinical evidence of the primary stage is referred to as syphilis d' emblée. Here we report a series of six cases in male patients. Five out of six patients presented with multiple, non-pruritic, macular palmar, and/or plantar lesions. One patient had typical facial and perianal lesions of condyloma lata. The diagnosis was confirmed by a reactive VDRL with titers ranging from 1:16 to 1:64 and a positive Treponema pallidum hemagglutination assay (TPHA). Syphilis being a great imitator can present in different ways without a typical history of primary chancre following sexual exposure, and can mimic many dermatological disorders in its secondary stage. Unless physicians have a high index of suspicion, the diagnosis may be missed. Early identification aids in prompt initiation of therapy and prevention of disease progression to chronic stages and systemic manifestations.

Published
2022
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22. Perioperative neurocognitive and functional neuroimaging trajectories in older APOE4 carriers compared with non-carriers: secondary analysis of a prospective cohort study

Author

Bengali, S., Bennett, E., Brassard, R., Brigman, B., Bullock, M., Carter, J., Chapman, J., Colin, B., D'Amico, T., DeOrio, J., Esclamado, R., Ferrandino, M., Gadsden, J., Gardner, J., Garrigues, G., Giattino, C., Grant, S., Guercio, J., Gupta, D., Habib, A., Harpole, D., Hartwig, M., Hu, J., Iboaya, E., Inman, B., Khan, A., Lagoo-Deenadayalan, S., Laskowitz, D., Lee, P., Lee, W., Lemm, J., Levinson, H., Mantyh, C., McDonagh, D., Migaly, J., Mithani, S., Moul, J., Newman, M., Ohlendorf, B., Perez, A., Peterson, A., Preminger, G., Quinones, Q., Ray, A., Roberts, K., Robertson, C., Roman, S., Runyon, S., Sandler, A., Sbahi, F., Scheri, R., Smith, K., Talbot, L., Thacker, J., Thomas, J., Tong, B., Toulgoat-Dubois, Y., Tu, A., Vaslef, S., Woldorff, M., Waldron, N., Wang, X., Young, C., Browndyke, Jeffrey N., Wright, Mary C., Yang, Rosa, Syed, Ayesha, Park, John, Hall, Ashley, Martucci, Katherine, Devinney, Michael J., Shaw, Leslie, Waligorska, Teresa, Moretti, Eugene W., Whitson, Heather E., Cohen, Harvey J., Mathew, Joseph P., and Berger, Miles

Published
2021
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26. Burns in the Older Adult

Author

Stanojcic, Mile, Jeschke, Marc G., Johanning, Jason, Section editor, Lagoo-Deenadayalan, Sandhya, Section editor, Rosenthal, Ronnie A., editor, Zenilman, Michael E., editor, and Katlic, Mark R., editor

Published
2020
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27. Small Bowel Obstruction in the Elderly

Author

Morano, William F., Bowne, Wilbur B., Johanning, Jason, Section editor, Lagoo-Deenadayalan, Sandhya, Section editor, Rosenthal, Ronnie A., editor, Zenilman, Michael E., editor, and Katlic, Mark R., editor

Published
2020
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29. Benign Colorectal Disease in the Elderly

Author

Pofahl, Walter E., Manwaring, Mark L., Johanning, Jason, Section editor, Lagoo-Deenadayalan, Sandhya, Section editor, Rosenthal, Ronnie A., editor, Zenilman, Michael E., editor, and Katlic, Mark R., editor

Published
2020
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30. Total Joint Replacement

Author

Mears, Simon C., Sullivan, Nicole M., Johanning, Jason, Section editor, Lagoo-Deenadayalan, Sandhya, Section editor, Rosenthal, Ronnie A., editor, Zenilman, Michael E., editor, and Katlic, Mark R., editor

Published
2020
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31. Diverticulitis and Appendicitis in the Elderly

Author

Thornton, Scott C., Reguero Hernandez, Jorge L., Johanning, Jason, Section editor, Lagoo-Deenadayalan, Sandhya, Section editor, Rosenthal, Ronnie A., editor, Zenilman, Michael E., editor, and Katlic, Mark R., editor

Published
2020
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32. Hip Fracture

Author

Mears, Simon C., Johanning, Jason, Section editor, Lagoo-Deenadayalan, Sandhya, Section editor, Rosenthal, Ronnie A., editor, Zenilman, Michael E., editor, and Katlic, Mark R., editor

Published
2020
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33. Elderly Donors in Transplantation

Author

Gilmore, Brian, Barbas, Andrew, Johanning, Jason, Section editor, Lagoo-Deenadayalan, Sandhya, Section editor, Rosenthal, Ronnie A., editor, Zenilman, Michael E., editor, and Katlic, Mark R., editor

Published
2020
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35. Esophageal Cancer in the Elderly

Author

Shende, Manisha, Reddy, Neha, Johanning, Jason, Section editor, Lagoo-Deenadayalan, Sandhya, Section editor, Rosenthal, Ronnie A., editor, Zenilman, Michael E., editor, and Katlic, Mark R., editor

Published
2020
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36. Breast Cancer in Elderly Women

Author

Morrow, Monica, Petruolo, Oriana, Johanning, Jason, Section editor, Lagoo-Deenadayalan, Sandhya, Section editor, Rosenthal, Ronnie A., editor, Zenilman, Michael E., editor, and Katlic, Mark R., editor

Published
2020
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37. Benign Disease of Stomach and Duodenum

Author

Corey, Britney L., Grams, Jayleen M., Christein, John D., Vickers, Selwyn M., Johanning, Jason, Section editor, Lagoo-Deenadayalan, Sandhya, Section editor, Rosenthal, Ronnie A., editor, Zenilman, Michael E., editor, and Katlic, Mark R., editor

Published
2020
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38. Gastric Cancer in the Elderly

Author

McCracken, Emily, Hatch, Sarah, Blazer, Dan G., III, Johanning, Jason, Section editor, Lagoo-Deenadayalan, Sandhya, Section editor, Rosenthal, Ronnie A., editor, Zenilman, Michael E., editor, and Katlic, Mark R., editor

Published
2020
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42. Benign and Malignant Tumors of the Liver

Author

White, Rebekah R., Menon, Vijay G., Johanning, Jason, Section editor, Lagoo-Deenadayalan, Sandhya, Section editor, Rosenthal, Ronnie A., editor, Zenilman, Michael E., editor, and Katlic, Mark R., editor

Published
2020
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43. Elderly Transplant Recipients

Author

Rege, Aparna, Nanavati, Aditya, Brennan, Todd V., Johanning, Jason, Section editor, Lagoo-Deenadayalan, Sandhya, Section editor, Rosenthal, Ronnie A., editor, Zenilman, Michael E., editor, and Katlic, Mark R., editor

Published
2020
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45. Abdominal Wall Hernias in the Elderly

Author

Buretta, Kate J., Hein, Rachel E., Erdmann, Detlev, Johanning, Jason, Section editor, Lagoo-Deenadayalan, Sandhya, Section editor, Rosenthal, Ronnie A., editor, Zenilman, Michael E., editor, and Katlic, Mark R., editor

Published
2020
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46. Cardiac Surgery in the Older Adult

Author

Torbiak, Lindsay, Stammers, Andrew, van Ineveld, Cornelia, Arora, Rakesh C., Johanning, Jason, Section editor, Lagoo-Deenadayalan, Sandhya, Section editor, Rosenthal, Ronnie A., editor, Zenilman, Michael E., editor, and Katlic, Mark R., editor

Published
2020
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47. Skin Lesions and Pressure Ulcers

Author

Kraft, Elizabeth, Cho, Kevin, Hunter, John G., Johanning, Jason, Section editor, Lagoo-Deenadayalan, Sandhya, Section editor, Rosenthal, Ronnie A., editor, Zenilman, Michael E., editor, and Katlic, Mark R., editor

Published
2020
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49. Gynecologic Disorders in the Older Woman

Author

Meyer, Isuzu, Howard, Tera F., Smith, Haller J., Kim, Kenneth H., Richter, Holly E., Johanning, Jason, Section editor, Lagoo-Deenadayalan, Sandhya, Section editor, Rosenthal, Ronnie A., editor, Zenilman, Michael E., editor, and Katlic, Mark R., editor

Published
2020
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50. Pulmonary Surgery for Malignant Disease in Older Adults

Author

Fox, Sam, Bravo-Iñiguez, Carlos, De Leon, Luis, Tarascio, Jeff, Jaklitsch, Michael, Johanning, Jason, Section editor, Lagoo-Deenadayalan, Sandhya, Section editor, Rosenthal, Ronnie A., editor, Zenilman, Michael E., editor, and Katlic, Mark R., editor

Published
2020
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