Daniel P O'Connor

University of Houston, Houston, Texas, United States

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Publications (112)280.28 Total impact

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    ABSTRACT: We developed the policy indicator checklist (PIC) to identify and measure policies for calorie-dense foods and sugar-sweetened beverages to determine how policies are clustered across multiple settings. In 2012 and 2013 we used existing literature, policy documents, government recommendations, and instruments to identify key policies. We then developed the PIC to examine the policy environments across 3 settings (communities, schools, and early care and education centers) in 8 communities participating in the Childhood Obesity Research Demonstration Project. Principal components analysis revealed 5 components related to calorie-dense food policies and 4 components related to sugar-sweetened beverage policies. Communities with higher youth and racial/ethnic minority populations tended to have fewer and weaker policy environments concerning calorie-dense foods and healthy foods and beverages. The PIC was a helpful tool to identify policies that promote healthy food environments across multiple settings and to measure and compare the overall policy environments across communities. There is need for improved coordination across settings, particularly in areas with greater concentration of youths and racial/ethnic minority populations. Policies to support healthy eating are not equally distributed across communities, and disparities continue to exist in nutrition policies. (Am J Public Health. Published online ahead of print March 19, 2015: e1-e8. doi:10.2105/AJPH.2015.302559).
    American Journal of Public Health 03/2015; 105(5):e1-e8. DOI:10.2105/AJPH.2015.302559 · 4.23 Impact Factor
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    ABSTRACT: Purpose: Individual perceptions of one's neighborhood environment influence decisions about physical activity participation. Differences between single-family housing neighborhoods versus multi-family housing neighborhoods may affect perceptions and lead to varying responses on surveys designed to assess perceptions of the neighborhood environment for physical activity. This study tested the factorial invariance for the Physical Activity Neighborhood Environment Survey (PANES) between residents of single-family versus multi-family housing neighborhoods. Method: This study was a secondary data analysis of PANES ratings from African American and Hispanic or Latina women (n = 324) who participated in the Health Is Power study (NCI R01CA109403), a multi-site, community-based trial to investigate the relationship between neighborhood factors and physical activity adoption and maintenance. Factorial invariance was tested using a series of nested confirmatory factor analysis models. Results: The final model was a 2nd-order factor structure with partial invariance of item intercepts. The 2nd-order factor structure and the relationships of the PANES items to the 1st-order factors (amenable, unsafe, and walkable) and of the 1st-order factors to the 2nd-order factor (environment) were invariant between the single-family and multi-family housing neighborhood groups. Conclusion: These findings support the construct validity of PANES, which can be considered valid for measuring neighborhood perceptions among residents of neighborhoods with different housing types.
    Research quarterly for exercise and sport 03/2015; DOI:10.1080/02701367.2015.1008965 · 1.26 Impact Factor
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    ABSTRACT: The ex vivo generation of monocyte-derived-dendritic cells (mo-DCs) has facilitated the use of DCs in immunotherapy research. However, low blood monocyte numbers frequently limit the manufacture of sufficient numbers of mo-DCs for subsequent experimental and clinical procedures. Because exercise mobilizes monocytes to the blood, we tested if acute dynamic exercise by healthy adults would augment the generation of mo-DCs without compromising their differentiation or function. We compared mo-DC generation from before- and after-exercise blood over 8-days of culture. Function was assessed by FITC-dextran uptake and the stimulation of autologous cytomegalovirus (pp65)-specific-T-cells. Supporting the hypothesis, we found a near fourfold increase in number of mo-DCs generated after-exercise. Furthermore, relative FITC-dextran uptake, differentiation rate, and stimulation of pp65-specific-T-cells did not differ between before- and after-exercise mo-DCs. We conclude that exercise enhances the ex vivo generation of mo-DCs without compromising their function, and so may overcome some limitations associated with manufacturing these cells for immunotherapy. Copyright © 2015 Elsevier Inc. All rights reserved.
    Cellular Immunology 02/2015; 295(1):52-59. DOI:10.1016/j.cellimm.2015.02.007 · 1.87 Impact Factor
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    ABSTRACT: Introduction: The Childhood Obesity Research Demonstration (CORD) project links public health and primary care interventions in three projects described in detail in accompanying articles in this issue of Childhood Obesity. This article describes a comprehensive evaluation plan to determine the extent to which the CORD model is associated with changes in behavior, body weight, BMI, quality of life, and healthcare satisfaction in children 2-12 years of age. Design/Methods: The CORD Evaluation Center (EC-CORD) will analyze the pooled data from three independent demonstration projects that each integrate public health and primary care childhood obesity interventions. An extensive set of common measures at the family, facility, and community levels were defined by consensus among the CORD projects and EC-CORD. Process evaluation will assess reach, dose delivered, and fidelity of intervention components. Impact evaluation will use a mixed linear models approach to account for heterogeneity among project-site populations and interventions. Sustainability evaluation will assess the potential for replicability, continuation of benefits beyond the funding period, institutionalization of the intervention activities, and community capacity to support ongoing program delivery. Finally, cost analyses will assess how much benefit can potentially be gained per dollar invested in programs based on the CORD model. Conclusions: The keys to combining and analyzing data across multiple projects include the CORD model framework and common measures for the behavioral and health outcomes along with important covariates at the individual, setting, and community levels. The overall objective of the comprehensive evaluation will develop evidence-based recommendations for replicating and disseminating community-wide, integrated public health and primary care programs based on the CORD model.
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    ABSTRACT: Objectives: To evaluate the radiographic and clinical outcomes of a systematic approach to exchange nailing for the treatment of aseptic femoral nonunions previously treated with an intramedullary nail. Design: Retrospective cohort. Setting: Tertiary referral center. Patients: Fifty aseptic femoral nonunions in 49 patients who presented with an intramedullary nail in situ an average of 25 months after the initial fracture nailing were evaluated. Intervention: Our systematic approach includes inserting an exchange nail at least 2 mm larger in diameter than the in situ nail, using a different manufacturer’s nail, static interlocking, correction of any metabolic and endocrine abnormalities, and secondary nail dynamization in cases showing slow progression toward healing. Main Outcomes Measurements: The outcome measures were radiographic and clinical evidence of nonunion healing and time to union. Results: All 50 femoral nonunions (100%) healed after this systematic approach to exchange nailing. The average time to achieve union was 7 months (range, 3–26 months). Conclusions: Utilization of this systematic approach of exchange nailing for the treatment of aseptic femoral nonunions resulted in a 100% healing rate. Key Words: fracture, ununited, intramedullary nail, femur, aseptic nonunion
    Journal of Orthopaedic Trauma 01/2015; 29(1):21-27. · 1.54 Impact Factor
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    ABSTRACT: The GoWoman project is developing and pilot testing the first small group weight management program designed to meet the unique needs of women with mobility impairments, a significantly underserved health disparity population. The project is conducted by a consortium of investigators at five universities in partnership with a Community Advisory Board of five women with mobility impairments. In adapting existing curriculum from the Diabetes Prevention Program, we added content related to the association between disability and weight gain, adaptive cooking, accessible kitchen design, an expanded range of physical activities, precautions against excessive activities and exercises, disability-related stress, and examples that reflect the life situation of women with disabilities. Participants track their progress through MyFitnessPal. Offering this intervention in the online virtual world of Second Life allows us to circumvent many of the geographic, transportation, logistic, disability, and personal barriers that women with mobility impairments face when attempting to participate in public weight loss programs. Our simulated accessible kitchen, caf, and physical activity venues also provide congenial and stigma-free environments for offering social interaction opportunities to reinforce the weight loss programming. The intervention consists of facilitated groups of 8-10 women who gather using their avatar and communicate using voice or text. Sessions last two hours and convene once a week for 16 weeks. We will demonstrate this virtual venue and present the results of the beta-test. We will discuss advantages and technical challenges of implementing interventions in virtual environments, and the implications of this study for mainstream weight loss programs.
    142nd APHA Annual Meeting and Exposition 2014; 11/2014
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    ABSTRACT: The purpose of this study was to evaluate outcomes in patients with rotator cuff tear arthropathy after staged bilateral reverse shoulder arthroplasties (RSAs) and to compare them with an age-, gender-, and diagnosis-matched control group with a unilateral RSA. We identified 11 patients with bilateral RSAs for rotator cuff tear arthropathy with a minimum of 2-year follow-up in a prospective shoulder arthroplasty registry. The bilateral group was matched to a control group of 19 patients with a unilateral RSA. Shoulder function scores, mobility, patient satisfaction, and activities of daily living were assessed preoperatively and at final follow-up. There was no statistical difference between the first RSA or second RSA and the control group regarding age, gender, or follow-up. No group differences were noted preoperatively for shoulder function scores or mobility (P > .10). All groups significantly improved on all shoulder function scores (Constant score, American Shoulder and Elbow Surgeons score, Western Ontario Osteoarthritis of the Shoulder index, Single Assessment Numeric Evaluation score) and mobility at final follow-up (all P < .01). There were no significant differences in shoulder function scores or mobility between the first and second RSA in the bilateral group or between either shoulder in the bilateral group and the unilateral group (all P > .10). Patient satisfaction improved and patients were successfully able to perform many important activities of daily living after bilateral RSAs. Patients with bilateral rotator cuff tear arthropathy can be advised that staged bilateral RSAs can be successful when indicated. Improvements in shoulder function scores, patient satisfaction, and mobility are possible for both the first RSA and the second RSA. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.
    Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.] 10/2014; 24(3). DOI:10.1016/j.jse.2014.08.008 · 2.37 Impact Factor
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    ABSTRACT: Management of periprosthetic infection after reverse shoulder arthroplasty (RSA) remains a challenge. Whereas the infection rate after RSA has improved, more information would be helpful to identify patient risk factors for infection after RSA. The purpose of this study was to evaluate risk factors for infection after RSA.
    Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.] 08/2014; 24(2). DOI:10.1016/j.jse.2014.05.020 · 2.37 Impact Factor
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    ABSTRACT: Blood flow restricted resistance exercise improves muscle strength; however, the cardiovascular response is not well understood. This investigation measured local vascular responses, tissue oxygen saturation (StO2), and cardiovascular responses during supine unilateral leg press and heel raise exercise in four conditions: high load with no occlusion cuff (HL), low load with no occlusion cuff (LL), and low load with occlusion cuff pressure set at 1.3 times resting diastolic blood pressure (BFRDBP) or at 1.3 times resting systolic blood pressure (BFRSBP). Subjects (N=13) (men/women 5/8, 31.8±12.5 yr, 68.3±12.1 kg, mean±SD) performed 3 sets of leg press and heel raise to fatigue with 90-s rest. Artery diameter, velocity time integral (VTI), and stroke volume (SV) were measured using two-dimensional and Doppler ultrasound at rest and immediately after exercise. Heart rate (HR) was monitored using a 3-lead ECG. Finger blood pressure (BP) was acquired by photoplethysmography. Vastus lateralis StO2 was measured using near-infrared spectroscopy (NIRS). A repeated-measures ANOVA was used to analyze exercise work and StO2. Multi-level modeling was used to evaluate the effect of exercise condition on vascular and cardiovascular variables. Statistical significance was set a priori at P<0.05. Artery diameter did not change from baseline during any of the exercise conditions. Blood flow increased after exercise in each condition except BFRSBP. StO2 decreased during exercise and recovered to baseline levels during rest only in LL and HL. HR, SV, and cardiac output (Q) responses to exercise were blunted in BFR. BP was elevated during rest intervals in BFR. Our results demonstrate that cuff pressure alters the hemodynamic responses to resistance exercise. These findings warrant further evaluations in individuals presenting cardiovascular risk factors.
    Medicine and science in sports and exercise 08/2014; 46(8). DOI:10.1249/MSS.0000000000000253 · 4.46 Impact Factor
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    ABSTRACT: The purpose of this study was to determine whether self-regulation of eating in minority preschool-aged children mediates the relationship between parent feeding practices and child weight. Participants were 299 low-income African American and Hispanic parents and their preschool-aged children who participated in Head Start. Parents completed questionnaires about controlling feeding practices (pressure to eat, restriction) and children's appetitive characteristics (enjoyment of food, food responsiveness, satiety responsiveness). Path analyses were used to determine whether children's self-regulation of eating mediated the relationship between feeding practices and child weight. Greater satiety responsiveness in African American preschool-age children partially mediated the inverse association between pressure to eat and children's weight, B (SE) = -0.073 (0.036), p < .05. Enjoyment of food and food responsiveness did not mediate the relationship between pressure to eat and weight in the African American sample, ps > .05, nor did appetitive characteristics mediate the relationship between restriction and child weight, ps > .05. Appetitive characteristics did not mediate the relationship between controlling feeding practices and child weight in the Hispanic sample, ps >.05. Implications include the need for culturally sensitive self-report measures and for researchers to account for the possible effects of racial/ethnic differences when designing interventions.
    Appetite 06/2014; 81. DOI:10.1016/j.appet.2014.06.014 · 2.52 Impact Factor
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    ABSTRACT: The purpose of this study is to evaluate the effectiveness of a systematic approach to exchange nailing for the treatment of aseptic tibial nonunion. Retrospective cohort. Tertiary referral center. Forty-six aseptic tibial nonunion sites in forty patients (2 bilateral., 4 segmental) that presented with an intramedullary nail (IMN) an average of 16 months after the initial treatment. Insertion of an exchange nail of at least > 2 mm diameter than the prior nail using a different manufacturer's nail, static interlocking, partial fibulectomy in a select group of patients. and correction of underlying metabolic and endocrine abnormalities. Union rate, time to union. Forty-five of 46 tibial nonunion sites (98%) healed at an average of 4.8 months. Patient selection criteria and a systematic approach to exchange nailing for tibial nonunion is highly successful. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
    Journal of orthopaedic trauma 05/2014; 29(1). DOI:10.1097/BOT.0000000000000151 · 1.54 Impact Factor
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    ABSTRACT: Few studies have investigated changes in adiposity and fitness during the academic year (AY) and summer season (SS) in minority children. This study aimed to assess if adiposity indicators and fitness change during the school AY and SS in Hispanic children. One hundred nineteen low-income Hispanic children (9.2 ± 0.8) participated in the study. Demographic, body weight and height, percent body fat (% BF), and aerobic endurance were assessed at 3 time points: measurement 1 (M1), beginning of AY; M2, end of AY; and M3, end of SS. Using weight and height, body mass index (BMI) was calculated and normalized (BMI z-scores). Mixed effects between-within-subjects analysis of variance (ANOVA) design was used to examine changes in selected variables. A significant decrease of BMI z-scores in overweight children (p = .024) was observed during the AY only, but not during the SS. Percent BF increased significantly over the AY and SS (p < .001), particularly in girls. Aerobic endurance showed a significant increase over the AY (p < .001), but it did not change over the SS (p = .552). Results indicated that the SS might place Hispanic children at increased risk for additional adiposity and lower fitness.
    Journal of School Health 04/2014; 84(4):233-8. DOI:10.1111/josh.12141 · 1.66 Impact Factor
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    ABSTRACT: This study assesses the failure rate of soft-tissue versus hardware fixation of biceps tenodesis by ultrasound to determine if the expense of a hardware tenodesis technique is warranted. Seventy-two patients that underwent arthroscopic biceps tenodesis over a 3-year period were evaluated using postoperative ultrasonography and clinical examination. The tenodesis technique employed was either a soft-tissue technique with sutures or an interference screw technique using hardware based on surgeon preference. Patient age was 57.9 years on average with ultrasound and clinical examination done at an average of 9.3 months postoperatively. Thirty-one patients had a hardware technique and 41 a soft-tissue technique. Overall, 67.7% of biceps tenodesis done with hardware were intact, compared with 75.6% for the soft-tissue technique by ultrasound (P = .46). Clinical evaluation indicated that 80.7% of hardware techniques and 78% of soft-tissue techniques were intact. Average material cost to the hospital for the hardware technique was $514.32, compared with $32.05 for the soft-tissue technique. Biceps tenodesis success, as determined by clinical deformity and ultrasound, was not improved using hardware as compared to soft-tissue techniques. Soft-tissue techniques are equally efficacious and more cost effective than hardware techniques.
    American journal of orthopedics (Belle Mead, N.J.) 02/2014; 43(2):62-5.
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    ABSTRACT: Fast-food restaurants (FFR) are prevalent. Binge eating is common among overweight and obese women. For women prone to binge eating, neighbourhood FFR availability (i.e. the neighbourhood around one's home) may promote poor diet and overweight/obesity. The present study tested the effects of binge eating and neighbourhood FFR availability on diet (fat and total energy intake) and BMI among African American and Hispanic/Latino women. All measures represent baseline data from the Health is Power randomized clinical trial. The numbers of FFR in participants' neighbourhoods were counted and dichotomized (0 or ≥1 neighbourhood FFR). Participants completed measures of binge eating status and diet. Weight and height were measured and BMI calculated. 2 (binge eating status) × 2 (neighbourhood FFR availability) ANCOVA tested effects on diet and BMI while controlling for demographics. Houston and Austin, TX, USA. African American and Hispanic/Latino women aged 25-60 years. Of the total sample (n 162), 48 % had 1-15 neighbourhood FFR and 29 % were binge eaters. There was an interaction effect on BMI (P = 0·05). Binge eaters with ≥1 neighbourhood FFR had higher BMI than non-binge eaters or binge eaters with no neighbourhood FFR. There were no significant interactions or neighbourhood FFR main effects on total energy or fat intake (P > 0·05). A main effect of binge eating showed that binge eaters consumed more total energy (P = 0·005) and fat (P = 0·005) than non-binge eaters. Binge eaters represented a substantial proportion of this predominantly overweight and obese sample of African American and Hispanic/Latino women. The association between neighbourhood FFR availability and weight status is complicated by binge eating status, which is related to diet.
    Public Health Nutrition 01/2014; 18(02):1-9. DOI:10.1017/S1368980013003546 · 2.48 Impact Factor
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    ABSTRACT: Obesity has been associated with accelerated biological aging and immunosenescence. As the prevalence of childhood obesity is increasing, we wanted to determine if associations between obesity and immunosenescence would manifest in children. We studied 123 Mexican-American adolescents aged 10 to 14 (mean 12.3 ± 0.7) years, with body weights ranging from 30.1 to 115.2 kg (mean 52.5 ± 14.5 kg). Blood samples were obtained to determine proportions of naïve, central memory (CM), effector memory (EM), senescent and early, intermediate and highly differentiated subsets of CD4+ and CD8+ T-cells. Overweight and obese children had significantly lowered proportions of early CD8+ T-cells (B= -11.55% and - 5.51% respectively) compared to healthy weight. Overweight children also had more EM (B=+7.53%), late (B=+8.90%) and senescent (B=+4.86%) CD8+ T-cells than healthy weight children, while obese children had more intermediate CD8+ (B=+4.59%), EM CD8+ (B=+5.49%), late CD4+ (B=+2.01%) and senescent CD4+ (B=+0.98%) T-cells compared to healthy weight children. These findings withstood adjustment for potentially confounding variables including age, gender and latent CMV and EBV infections. We conclude that excess body mass, even in adolescence, may accelerate immunosenescence and predispose children to increased risks of incurring immune related health problems in adulthood.
    Clinical & Experimental Immunology 01/2014; DOI:10.1111/cei.12267 · 3.28 Impact Factor
  • Mark R Brinker, Bryan D Hanus, Milan Sen, Daniel P O'Connor
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    ABSTRACT: Tibial nonunion is disabling, but to our knowledge no quantitative evaluation of its effect on health-related quality of life has been reported. We evaluated 243 tibial shaft fracture nonunions in 237 consecutive patients (seventy-nine female [age, 49.4 ± 14.9 years] and 158 male [age, 46.3 ± 15.4 years]) who were referred to a single surgeon at our tertiary care center over a ten-year period. The most frequently affected tibial segment was the distal third (49%), and infection was present in 18% of all cases. The Short Form (SF)-12 Physical Component Summary score averaged 27.4 ± 6.7, indicating an extremely disabling effect on physical health. The AAOS (American Academy or Orthopaedic Surgeons) Lower Limb Core Scale score averaged 52.0 ± 19.4, also consistent with high levels of physical disability attributable to the lower limb. The SF-12 Mental Component Summary score averaged 42.3 ± 7.1, indicating a substantial detrimental effect on mental health. The impact of tibial shaft fracture nonunion on physical health was comparable with the reported impact of end-stage hip arthrosis and worse than that of congestive heart failure. Tibial shaft fracture nonunion is a devastating chronic medical condition that negatively affects both physical and mental health and quality of life. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
    The Journal of Bone and Joint Surgery 12/2013; 95(24):2170-6. DOI:10.2106/JBJS.L.00803 · 4.31 Impact Factor
  • Mark R Brinker, Daniel P O'Connor
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    ABSTRACT: Modern interest in patient-reported outcomes measures (PROMs) in orthopaedics dates back to the mid-1980s. While gradual growth of activity in this area has occurred over the past 25 years, the extent to which this research methodology is applied in clinical practice to improve patient care is unclear. WHERE ARE WE NOW?: Historically, clinical research in orthopaedics has focused on the technical success of treatment, and objective indicators such as mortality, morbidity, and complications. By contrast, the PROMs framework focuses on effects of treatment described in terms of relief of symptoms, restoring functional ability, and improving quality of life. PROMs can be used to study the relative effects of disease, injury, and treatment across different health conditions. WHERE DO WE NEED TO GO?: All clinical research should begin with identifying clear and meaningful research questions so that the resources and efforts required for data collection result in useful data. Different consumers of research data have different perspectives on what comprises meaningful information. Involving stakeholders such as patients, providers, payers, and policy-makers when defining priorities in the larger research endeavor is one way to inform what type of data should be collected in a particular study. HOW DO WE GET THERE?: Widespread collection of outcomes data would potentially aid these stakeholders by identifying best practices, benefits and costs, and important patient or practice characteristics related to outcomes. Several initiatives currently underway may help systematic collection of PROMs, create efficient systems, and foster collaborations to provide support and resources to minimize costs.
    Clinical Orthopaedics and Related Research 09/2013; 471(11). DOI:10.1007/s11999-013-3265-3 · 2.88 Impact Factor
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    ABSTRACT: The purpose of this study was to compare the structural outcomes of a single-row rotator cuff repair and double-row suture bridge fixation after arthroscopic repair of a full-thickness supraspinatus rotator cuff tear. We evaluated with diagnostic ultrasound a consecutive series of ninety shoulders in ninety patients with full-thickness supraspinatus tears at an average of 10 months (range, 6-12) after operation. A single surgeon at a single hospital performed the repairs. Inclusion criteria were full-thickness supraspinatus tears less than 25 mm in their anterior to posterior dimension. Exclusion criteria were prior operations on the shoulder, partial thickness tears, subscapularis tears, infraspinatus tears, combined supraspinatus and infraspinatus repairs and irreparable supraspinatus tears. Forty-three shoulders were repaired with single-row technique and 47 shoulders with double-row suture bridge technique. Postoperative rehabilitation was identical for both groups. Ultrasound criteria for healed repair included visualization of a tendon with normal thickness and length, and a negative compression test. Eighty-three patients were available for ultrasound examination (40 single-row and 43 suture-bridge). Thirty-two of 40 patients (80%) with single-row repair demonstrated a healed rotator cuff repair compared to 40/43 (93%) patients with suture-bridge repair (P = .018). Arthroscopic double-row suture bridge repair (transosseous equivalent) of an isolated supraspinatus rotator cuff tear resulted in a significantly higher tendon healing rate (as determined by ultrasound examination) when compared to arthroscopic single-row repair.
    Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.] 09/2013; DOI:10.1016/j.jse.2013.06.020 · 2.37 Impact Factor
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    ABSTRACT: The Energy Balance Study (EBS) was a comprehensive study designed to determine over a period of 12 months the associations of caloric intake and energy expenditure on changes in body weight and composition in a population of healthy men and women. EBS recruited men and women aged 21 to 35 years with a body mass index between 20 and 35 kg/m2. Measurements of energy intake and multiple objective measures of energy expenditure, as well as other physiological, anthropomorphic and psychosocial measurements, were made quarterly. Resting metabolic rate and blood chemistry were measured at baseline, 6 and 12 months. Four hundred and thirty (218 women and 212 men) completed all baseline measurements. There were statistically significant differences by sex uncovered for most anthropomorphic, physiological and behavioral variables. Only percent of kcals from fat and alcohol intake, as well as energy expenditure in light activity and very vigorous activity were not different. Self-reported weight change (mean +/- SD) over the previous year were 0.92 +/- 5.24 kg for women and--1.32 +/- 6.1 kg for men. Resting metabolic rate averages by sex were 2.88 +/- 0.35 ml/kg/min for women and 3.05 +/- 0.33 ml/kg/min for men. Results from EBS will inform our understanding of the impact of energy balance components as they relate to changes in body weight and composition. Initial findings suggest a satisfactory distribution of weight change to allow for robust statistical analyses. Resting metabolic rates well below the standard estimate suggest that the evaluation of the components of total energy expenditure will be impactful for our understanding of the roles of energy intake and expenditure on changes in energy utilization and storage.
    Research quarterly for exercise and sport 09/2013; 84(3):275-86. DOI:10.1080/02701367.2013.816224 · 1.26 Impact Factor
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    ABSTRACT: The purpose of this study was to determine whether morphine would be as effective as bupivacaine for postoperative pain control after knee arthroscopy with no worsening of the side effect profile. Eighty-two patients who underwent partial meniscectomy, chondral debridement, or both were prospectively randomized to receive 10 mg of morphine (10-cc volume) or 10 cc of .5% bupivacaine immediately postoperatively. Visual analog scale scores and side effect profiles were recorded in the postanesthesia care unit, in the transitional care unit, and then every 4 hours postoperatively until 24 hours. In-hospital data were available for all 82 patients, but postdischarge data were available for only 64 patients. Visual analog scale scores in the postanesthesia care unit decreased from 3.4 on admission to 2.4 on discharge for the morphine group and from 2.6 to 2.4 for the bupivacaine group (P>.217, all time points). Medication use was the same for both groups in the hospital (62% and 78%, respectively) with no statistical difference. Visual analog scale scores decreased from 3.0 to 1.5 for the morphine group and from 2.8 to 1.8 for the bupivacaine group between 4 and 24 hours postoperatively (P>.376, all time points). Medication use decreased between 4 and 24 hours postoperatively for both groups, from 71.7% to 52.9%, respectively, with no statistical difference at all time points. Four patients in the morphine group and 1 patient in the bupivacaine group experienced side effects. This study indicates that 10 mg of intra-articular morphine is as effective as 10 cc of .5% bupivacaine for postoperative pain control for partial meniscectomy and chondral debridement of the knee. It minimally increases side effects initially and circumvents the issue of chondral toxicity of bupivacaine.
    Orthopedics 09/2013; 36(9):e1121-7. DOI:10.3928/01477447-20130821-12 · 0.98 Impact Factor

Publication Stats

1k Citations
280.28 Total Impact Points

Institutions

  • 2006–2015
    • University of Houston
      • Department of Health and Human Performance
      Houston, Texas, United States
  • 2012
    • University of South Carolina
      • Department of Exercise Science
      Columbia, South Carolina, United States
  • 2011
    • University of Alabama at Birmingham
      • Department of Epidemiology
      Birmingham, AL, United States
  • 2005–2007
    • Clinique Sainte Anne
      Strasburg, Alsace, France
    • University of Texas Medical School
      • Department of Orthopaedic Surgery
      Houston, Texas, United States
    • University of Pécs
      Fuenfkirchen, Baranya, Hungary
  • 2004–2006
    • Baylor College of Medicine
      Houston, Texas, United States
    • University of Texas at Arlington
      Arlington, Texas, United States
    • University of Texas Health Science Center at Houston
      Houston, Texas, United States
  • 2003
    • Tulane University
      New Orleans, Louisiana, United States