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Hiram polk

Norman Galbraith, Samuel Walker, Jane Carter, Hiram C Polk
BACKGROUND: Patients who survive the early phases of major sepsis and trauma can have greater susceptibility to nosocomial infection later. One cause may be impaired monocyte function, which can leave the patient at risk of overwhelming sepsis and multi-organ dysfunction. Efforts to target this immune defect have been fraught with challenges, with many questions unanswered. We summarized the past and current and likely future therapeutic approaches to augmentation of monocyte function in the surgical patient...
October 2016: Surgical Infections
Norman Galbraith, Samuel Walker, Susan Galandiuk, Sarah Gardner, Hiram C Polk
BACKGROUND: Trauma, major elective surgery, and overt sepsis can lead to a cascade of immunological change. A subset of these patients will have a degree of immune suppression that leads to hyporesponsive innate defenses, increasing the risk of infective co-morbidity and death. This article is an overview of monocyte impairment in the high-risk surgical patient. Specifically, our primary focus is on observations made pertaining to monocyte function and pathophysiological mechanisms underpinning this impairment...
June 2016: Surgical Infections
Adrian T Billeter, Norman Galbraith, Samuel Walker, Chelsea Lawson, Sarah A Gardner, Harshini Sarojini, Susan Galandiuk, Hiram C Polk
INTRODUCTION: Hypothermia is a well-known risk factor for postoperative complications because it prolongs the monocyte inflammatory response. The purpose of this study was to investigate whether temperature-activated ion channels (transient receptor protein channels [TRP] A1 and V1) mediate the effects of temperature on monocytes. METHODS: Primary human monocytes were isolated and stimulated with lipopolysaccharide at 32°C or 39°C. RNA was isolated for analysis of microRNA (miR)-155 expression, and cytokines in the supernatant were measured with an enzyme-linked immunosorbent assay...
September 2015: Surgery
Adrian T Billeter, Jonathan Rice, Devin Druen, Seth Sklare, Samuel Walker, Sarah A Gardner, Hiram C Polk
OBJECTIVE: To investigate whether warming to normal body temperature or to febrile range temperature (39°C) is able to reverse the detrimental effects of hypothermia. BACKGROUND: Unintentional intraoperative hypothermia is a well-described risk factor for surgical site infections but also sepsis. We have previously shown that hypothermia prolongs the proinflammatory response whereas normothermia and especially febrile range temperature enhance the anti-inflammatory response...
March 2016: Annals of Surgery
Adrian T Billeter, Jason Hellmann, Henry Roberts, Devin Druen, Sarah A Gardner, Harshini Sarojini, Susan Galandiuk, Sufan Chien, Aruni Bhatnagar, Matthew Spite, Hiram C Polk
Therapeutic hypothermia is commonly used to improve neurological outcomes in patients after cardiac arrest. However, therapeutic hypothermia increases sepsis risk and unintentional hypothermia in surgical patients increases infectious complications. Nonetheless, the molecular mechanisms by which hypothermia dysregulates innate immunity are incompletely understood. We found that exposure of human monocytes to cold (32°C) potentiated LPS-induced production of TNF and IL-6, while blunting IL-10 production. This dysregulation was associated with increased expression of microRNA-155 (miR-155), which potentiates Toll-like receptor (TLR) signaling by negatively regulating Ship1 and Socs1...
December 2014: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
G Swope Munday, Peter Deveaux, Henry Roberts, Donald E Fry, Hiram C Polk
BACKGROUND: We present a comprehensive systematic review of the effect of Surgical Care Improvement Project (SCIP) measures on surgical site infections (SSIs) as related to SCIP compliance. DATA SOURCES: A systematic review of the peer-reviewed literature was performed on PubMed, Medline, and Cochrane database group using their own search engines. Keywords used were Surgical Care Improvement Project (SCIP), adherence, compliance, surgical site infection (SSI), infection bundle, antibiotics, perioperative antibiotics, and combinations thereof...
November 2014: American Journal of Surgery
Adrian T Billeter, Samuel F Hohmann, Devin Druen, Robert Cannon, Hiram C Polk
INTRODUCTION: Hypothermia occurs in as many as 7% of elective colorectal operations and is an underestimated risk factor for complications and death. Rewarming of hypothermic patients alone is not sufficient to prevent such adverse events. We investigated the outcomes of patients who became hypothermic (<35°C) after elective operations and compared them with closely matched, nonhypothermic operative patients to better define the impact of hypothermia on surgical outcomes, as well as to identify independent risk factors for hypothermia...
November 2014: Surgery
Adrian T Billeter, Frank B Miller, Brian G Harbrecht, Wanda Bowen, Matthew J Stephens, Gregory C Postel, Jason W Smith, Matthew Penta, Royce Coleman, Glen A Franklin, Donald D Trunkey, Hiram C Polk
BACKGROUND: Stops at nontrauma centers for severely injured patients are thought to increase deaths and costs, potentially because of unnecessary imaging and indecisive/delayed care of traumatic brain injuries (TBIs). METHODS: We studied 754 consecutive blunt trauma patients with an Injury Severity Score greater than 20 with an emphasis on 212 patients who received care at other sites en route to our level 1 trauma center. RESULTS: Referred patients were older, more often women, and had more severe TBI (all P < ...
April 2014: American Journal of Surgery
Adrian T Billeter, Jason L Hellmann, Aruni Bhatnagar, Hiram C Polk
OBJECTIVE: This article reviews the current understanding of transient receptor potential ion channels (TRP channels) in health and disease. BACKGROUND: Transient receptor potential ion channels are a group of 27 channels that are expressed in all tissues. These channels play important roles in surgically important problems, such as chronic pain, susceptibility to infection, hypothermia, and some cancers. METHODS: A literature search was performed...
February 2014: Annals of Surgery
Adrian T Billeter, Rebecca E Barnett, Devin Druen, Hiram C Polk, Victor H van Berkel
Lung cancer is the most lethal cancer due to late detection in advanced stages; early diagnosis of lung cancer allows surgical treatment and improves the outcome. The prevalence of gastroesophageal reflux-related adenocarcinomas of the esophagus is increasing; repetitive surveillance endoscopies are necessary to detect development of cancer. A blood-based biomarker would simplify the diagnosis and treatment of both diseases. MicroRNAs (miRNAs) are short RNA strands that interfere with protein production. miRNAs play pivotal roles in cell homeostasis, and dysregulation of miRNAs can lead to the development of cancer...
2012: Seminars in Thoracic and Cardiovascular Surgery
Adrian T Billeter, Seth Sklare, Glen A Franklin, Jerry Wright, Gary Morgan, Paul E O'Flynn, Hiram C Polk
PURPOSE: Organ demand exceeds availability of transplantable organs. Organ procurement continues to suffer from failures to identify potential donors, inability to obtain consent for donation, as well as failures to retrieve certain organs as donor demographics change. The purpose of this article is to propose how sequentially introduced measures can increase organ donation rates as well as improve organ procurement. METHODS: We analysed the effect of stepwise improvements in the organ procurement process patients in a university-based surgical intensive care unit over a 20-year period...
November 2012: Injury
Adrian T Billeter, Motaz Qadan, Devin Druen, Sarah A Gardner, Tama The, Hiram C Polk
Unintentional hypothermia is a well-described risk factor for death and complications after elective and emergency surgery. The molecular mechanisms by which hypothermia exerts its detrimental effects are not well understood. Differences in cytokine production and the overall cell function have been reported under hypothermic conditions. We investigated the effect of a range of clinically relevant temperatures on cytokine production and microRNA (miRNA) expression in a whole-blood model. We found that there was a wide variation in tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and IL-10 production among different subjects, ranging from low to high TNF-α producers...
October 2012: Journal of Interferon & Cytokine Research
Adrian T Billeter, Hiram C Polk, Samuel F Hohmann, Motaz Qadan, Donald E Fry, Jeffrey R Jorden, Michael H McCafferty, Susan Galandiuk
BACKGROUND: Process measures constitute the focal point of surgical quality studies. High levels of compliance with such processes have not correlated with improved outcomes. Wide ranges of reported hospital death rates led us to hypothesize that survival after elective colon resection would be a legitimate outcomes measure for quality of surgical practice. STUDY DESIGN: We studied risk-adjusted hospital mortality rates of 85,260 patients in teaching hospitals as reported to the University HealthSystem Consortium (UHC) January 1, 2005 to March 31, 2011...
April 2012: Journal of the American College of Surgeons
Hiram C Polk, Kirby I Bland, E Christopher Ellison, Jay Grosfeld, Donald D Trunkey, Steven C Stain, Courtney M Townsend
OBJECTIVE(S): The goals of this focused meeting were to verify and clarify the causes and extent of the general surgery (GS) workforce shortfalls. We also sought to define workable solutions within the existing framework of medical accreditation and certification. BACKGROUND: Numerous peer-reviewed and lay reports describe a current and worsening availability of GS services, affecting rural areas as well as large cities, academia, and the military. METHOD: Primary recommendations were broadly agreed upon by attendee surgeons who were selected from numerous different professional scenarios and included 2 nonmedical observers...
April 2012: Annals of Surgery
Hiram C Polk
No abstract text is available yet for this article.
November 2011: American Surgeon
Adrian T Billeter, Devin Druen, Ziad M Kanaan, Hiram C Polk
No abstract text is available yet for this article.
January 2012: Surgery
Susan Galandiuk, Donald E Fry, Hiram C Polk
The numbers of unanswered questions are many. Can intraoperative application, such as topical antimicrobial use in pulsed lavage, reduce the microbial burden on the wound interface before closure? Can closed suction drains within the closed surgical incision reduce infection rates, especially in patients with a large body mass index? What is the role of delayed primary closure or secondary closure in the wound where obvious contamination has occurred, or in the circumstance of emergent colonic resection where considerable contamination is encountered from preexistent perforation? Should immediate negative-pressure wound dressings be applied in the open contaminated wound? These and many other questions still confront the surgeon in the challenge of the surgical wound in major colorectal surgery...
2011: Advances in Surgery
Kirby I Bland, David B Hoyt, Hiram C Polk, John E Niederhuber
No abstract text is available yet for this article.
October 2011: Annals of Surgery
Hiram C Polk
No abstract text is available yet for this article.
June 2011: American Journal of Surgery
Andrew W Kirkpatrick, Giuseppe Papia, Stuart A McCloskey, Hiram C Polk, Ozan Akca, Motaz Qadan
No abstract text is available yet for this article.
February 2011: Canadian Journal of Surgery. Journal Canadien de Chirurgie
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