Browsing by Author "Rea, Parker"

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    Global white matter microstructural abnormalities associated with addiction liability score in drug naïve youth
    (Springer Nature, 2018-02) Hulvershorn, Leslie; Hummer, Tom; Wu, Yu-Chien; Tarter, Ralph; Rea, Parker; Anand, Amit; Andrew Chambers, R.; Finn, Peter; Psychiatry, School of Medicine
    Abnormalities in brain white matter (WM) structure have been reported in youths having a family history of substance use disorders (SUDs). It was hypothesized that these abnormalities constitute features of the liability for SUDs transmitted across generations. The association between severity of intergenerational risk for SUD, measured by the Transmissible Liability Index (TLI), and white matter microstructure was examined. Diffusion tensor imaging (DTI) measured WM microstructure in forty-four drug-naïve 10-14 year-olds (N = 19 with parental SUD). Metrics of WM microstructure (i.e., fractional anisotropy, radial diffusivity, mean diffusivity and axial diffusivity) were quantified across the whole brain and in four tracts of interest: anterior corona radiata, superior and inferior longitudinal fasciculi and superior fronto-occipital fasciculi. The TLI was completed by the youths, their parents and, when available, their teachers. The relationship between WM structure and TLI score across the entire group was evaluated using linear multiple regression and between group comparisons were also examined. Fractional anisotropy and radial diffusivity in multiple tracts across the brain were significantly associated with TLI scores. Confirming and extending prior research, the findings indicate that global atypicality in WM tracts was linearly related to liability for eventual SUD development in drug naïve youths.
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    Results of Low Distal Femur Periprosthetic Fractures
    (Wolters Kluwer, 2022-02-28) Virkus, Walter; Lieder, Charles; Jang, Yohan; Rea, Parker; Gaski, Greg; Orthopaedic Surgery, School of Medicine
    Objectives- To compare retrograde intramedullary nail (RIMN) and open reduction internal fixation (ORIF) in very distal periprosthetic distal femur fractures (PDFF) to determine if RIMN is an acceptable option for these fractures that are often considered too distal for IMN due to limited bone stock. Design- Retrospective comparative series Setting- Level One trauma center Patients- Patients treated with fracture fixation for a very distal PDFF, defined as the fracture extending to the anterior flange of the implant or distal. Fifty-six patients met inclusion criteria, with eight excluded for less than twelve months of follow-up. Intervention- Fracture fixation with RIMN or ORIF Main Outcome Measurements- The primary outcome was unplanned return to surgery. Secondary outcomes included fracture union, radiographic alignment, Visual Analog Score (VAS) and Patient-Reported Outcome Measurement Information System (PROMIS) Physical Function (PF) and Pain Interference (PI). Results- Mean follow up was 27 months. Twelve patients were treated with ORIF and 36 with RIMN. Twenty-one fractures were at the flange and 27 extended distal to the flange. There were no differences between fixation methods with respect to reoperation, deep infection, nonunion, malunion, VAS pain score, and PROMIS PI score. Mean PROMIS PF score was higher in the RIMN group compared to ORIF. There were five reoperations in the RIMN group (14%) and three in the ORIF group (25%). Conclusion- This is the largest series, to our knowledge, of a subset of very distal PDFFs. The results suggest that RIMN may be an acceptable treatment option for these very difficult fractures.