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Hiram polk

Nicolas Ajkay, Neal Bhutiani, Bin Huang, Quan Chen, Jeffrey D Howard, Thomas C Tucker, Charles R Scoggins, Kelly M McMasters, Hiram C Polk
BACKGROUND: In January 2014, Kentucky expanded Medicaid coverage to include all individuals and families with incomes up to 33% above the federal poverty line. This study evaluated the early impact of Medicaid expansion on some aspects of the quality of breast cancer care in Kentucky. STUDY DESIGN: The Kentucky Cancer Registry was queried for all women aged 20 to 64 years diagnosed with breast cancer between 2011 and 2016. Demographic, tumor, and treatment characteristics were assessed for each year during this interval...
April 2018: Journal of the American College of Surgeons
Norman J Galbraith, Stephen Manek, Samuel Walker, Campbell Bishop, Jane V Carter, Meredith Cahill, Sarah A Gardner, Hiram C Polk, Susan Galandiuk
This study focuses on impaired monocyte function, which occurs in some patients after trauma, major elective surgery, or sepsis. This monocyte impairment increases the risk of secondary infection and death. We aimed to determine the influence IκK-16 had on monocytes using an ex-vivo model of human monocyte impairment. We included the effects of the well-studied comparators interferon-gamma (IFN-γ) and granulocyte-macrophage colony-stimulating factor (GM-CSF) on impaired monocytes. Primary human monocytes were stimulated with 10ng/mL of lipopolysaccharide (LPS) for 16h and then challenged with 100ng/mL LPS to assess the monocyte inflammatory response...
April 2018: Immunobiology
Hiram C Polk
This reflection retraces the evolution of early followers and leaders. Social change and early contributions set the stage for the current Association for Academic Surgery. Perhaps the most important contribution was Dr. George Zuidema's theme of inclusiveness. AAS was a decade ahead of its time in that regard.
September 2017: Journal of Surgical Research
Norman James Galbraith, James Burton, Mathew Brady Ekman, Joseph Kenney, Samuel Patterson Walker, Stephen Manek, Campbell Bishop, Jane Victoria Carter, Sarah Appel Gardner, Hiram C Polk
Excessive inflammatory responses in the surgical patient may result in cellular hypo-responsiveness, which is associated with an increased risk of secondary infection and death. microRNAs (miRNAs), such as miR-155, are powerful regulators of inflammatory signalling pathways including nuclear factor κB (NFκB). Our objective was to determine the effect of IκK-16, a selective blocker of inhibitor of kappa-B kinase (IκK), on miRNA expression and the monocyte inflammatory response. In a model of endotoxin tolerance using primary human monocytes, impaired monocytes had decreased p65 expression with suppressed TNF-α and IL-10 production (P < 0...
2017: PloS One
Jane V Carter, Hiram C Polk, Norman J Galbraith, Kelly M McMasters, William G Cheadle, Molly Poole, Susan Galandiuk
BACKGROUND: There are an increasing number of women in surgery. Previously, many questions focused upon their ability to complete surgical training and contribute fully to the surgical workforce. More meaningful information lies in identifying the long-term follow-up of where, and in what specialty, women residents eventually practice. METHODS: All residents entering general surgery training at the University of Louisville between 1996 and 2009 were studied. Comparison between men and women was performed for program completion, length of residency training, and eventual specialty practice...
June 6, 2017: American Journal of Surgery
Motaz Qadan, Andrew R Davies, Hiram C Polk, William H Allum, Murray F Brennan
No abstract text is available yet for this article.
January 2018: American Journal of Surgery
Harshini Sarojini, Adrian T Billeter, Sarah Eichenberger, Devin Druen, Rebecca Barnett, Sarah A Gardner, Norman J Galbraith, Hiram C Polk, Sufan Chien
We have reported a new phenomenon in acute wound healing following the use of intracellular ATP delivery-extremely rapid tissue regeneration, which starts less than 24 h after surgery, and is accompanied by massive macrophage trafficking, in situ proliferation, and direct collagen production. This unusual process bypasses the formation of the traditional provisional extracellular matrix and significantly shortens the wound healing process. Although macrophages/monocytes are known to play a critical role in the initiation and progression of wound healing, their in situ proliferation and direct collagen production in wound healing have never been reported previously...
2017: PloS One
Erica R H Sutton, Adrian Billeter, Devin Druen, Henry Roberts, Jonathan Rice
BACKGROUND: The organ procurement network recommends a surgeon record 15 cases as surgeon or assistant for laparoscopic donor nephrectomies (LDN) prior to independent practice. The literature suggests that the learning curve for improved perioperative and patient outcomes is closer to 35 cases. In this article, we describe our development of a model utilizing fresh tissue and objective, quantifiable endpoints to document surgical progress, and efficiency in each of the major steps involved in LDN...
March 25, 2017: Clinical Transplantation
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
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