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Selene G Parekh

Publications and source records attributed to Selene G Parekh.

7 recordsLinked to original sources
PubMed2026

Non-tobacco nicotine dependence and postoperative complications after total ankle arthroplasty: A propensity-matched cohort study.

BACKGROUND: The clinical impact of non-tobacco nicotine dependence (NTND) is poorly defined. This study evaluated the association between NTND and complications following total ankle arthroplasty (TAA). METHODS: A retrospective cohort study using the TriNetX Research Network was performed. Adults undergoing primary TAA (Current Procedural Terminology [CPT] 27702) between 2010 and 2025 were included. Patients were categorized into NTND (International Classification of Diseases, Tenth Revision [ICD-10]: F17, excluding tobacco-specific codes) and nonsmoker cohorts. Propensity score matching (1:1) yielded 939 NTND patients and 939 controls. Ninety-day medical and wound complications and ≥ 2-year mechanical outcomes were assessed. RESULTS: NTND patients had higher rates of 90-day readmission (11.7% vs 6.5%; OR 1.9), wound disruption (4.3% vs 2.6%; OR 1.7), surgical site infection (3.1% vs 1.6%; OR 2.0), and sepsis (2.4% vs 1.1%; OR 2.3). At a minimum 2-year follow-up, NTND was not associated with increased risk of mechanical complications. CONCLUSION: These findings challenge the assumption that smokeless nicotine products are benign in the perioperative setting and support incorporating NTND screening and cessation counseling into preoperative optimization protocols. Future prospective studies are warranted to further characterize the dose-dependent effects of non-tobacco nicotine exposure and to evaluate the impact of perioperative cessation strategies on outcomes following TAA. LEVEL OF EVIDENCE: IV.

Humans↗
PubMed2006

The morbidity associated with osteochondral harvest from asymptomatic knees for the treatment of osteochondral lesions of the talus.

BACKGROUND: Mosaic autogenous osteochondral transplantation has been used to treat large osteochondral defects. HYPOTHESIS: There is potential, previously unrecognized donor-site morbidity associated with osteochondral harvest from asymptomatic knees for the treatment of talar osteochondral defect lesions. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Fifteen patients underwent mosaic osteochondral transplantation to treat a talar osteochondral defect lesion, with 11 patients available for follow-up. A Lysholm knee score was used to assess donor-site morbidity at a mean follow-up of 47 months (range, 7-77 months). Mean age was 29 years (range, 21-44 years). A single surgical team performed the mosaicplasties. Significance was determined using the Student t test. RESULTS: All patients had asymptomatic knees preoperatively. Mean postoperative Lysholm score was 81 (range, 49-100). By Lysholm criteria, 5 rated as excellent, 2 as good, and 4 as poor. No significant difference was detected in terms of the harvest method or the number of grafts obtained from those having an excellent rating versus those having a good/poor rating. Patients rated as good/poor cited knee instability in daily activities as the most common problem. One had knee pain and patellar instability after osteochondral harvest by lateral arthrotomy that required a subsequent lateral retinacular release and tibial tubercle osteotomy. CONCLUSION: This study demonstrates that donor-site morbidity after osteochondral harvest can be significant. In this population, those who experienced a decline in knee function had problems performing activities of daily living. When performing these procedures, the authors recommend that surgeons consider these risks and discuss them with their patients.

Adult↗
PubMed2006

Outcomes of anterior cruciate ligament injuries to running backs and wide receivers in the National Football League.

BACKGROUND: Anterior cruciate ligament injuries are common in professional football players, and their career impact is unclear. PURPOSE: To quantify the affect of anterior cruciate ligament injuries on professional football player performance. STUDY DESIGN: Cohort study (prognosis); Level of evidence, 2. METHODS: Anterior cruciate ligament injury data from the National Football League were collected during a 5-year period (1998-2002) for running backs and wide receivers. Recorded variables included player age, experience, position, time to return to competition, and yearly total yards and touchdowns. Power ratings (total yards divided by 10 plus touchdowns multiplied by 6) were calculated for the injury season as well as for the 3 seasons before and after injury. A control group consisted of all running backs and wide receivers without an identified anterior cruciate ligament injury who competed in the 2000 season. RESULTS: Data were analyzed for 31 running backs and wide receivers with 33 anterior cruciate ligament injuries. More than one fifth of players never returned to a National Football League game. Returning players first competed in a game 55.8 +/- 5.4 weeks (mean +/- standard error) after injury. For the 24 anterior cruciate ligament-injured players with a minimum total power rating (sum of all 7 seasons) of 200 points, power rating per game played decreased from 9.9 +/- 1.1 preinjury to 6.5 +/- 0.9 postinjury. This decline in power rating per game played was statistically significant (P = .002) when compared with the change for the 146 control players. CONCLUSION: Nearly four fifths of National Football League running backs and wide receivers who sustain an anterior cruciate ligament injury return to play in a game. On return to competition, player performance of injured players is reduced by one third.

Adult↗
PubMed2004

Adoption of information technology by resident physicians.

The Internet represents a technological revolution that is transforming our society. In the healthcare industry, physicians have been typified as slow adopters of information technology. However, young physicians, having been raised in a computer-prevalent society, may be more likely to embrace technology. We attempt to characterize the use and acceptance of the Internet and information technology among resident physicians in a large academic medical center and to assess concerns regarding privacy, security, and credibility of information on the Internet. A 41-question survey was distributed to 150 pediatric, medical, and surgical residents at an urban, academic medical center. One hundred thirty-five residents completed the survey (response rate of 90%). Responses were evaluated and statistical analysis was done. The majority of resident physicians in our survey have adopted the tools of information technology. Ninety-eight percent used the Internet and 96% use e-mail. Two-thirds of the respondents used the Internet for healthcare-related purposes and a similar percentage thought that the Internet has affected their practice of medicine positively. The majority of residents thought that Internet healthcare services such as electronic medical records, peer-support websites, and remote patient monitoring would be beneficial for the healthcare industry. However, they are concerned about the credibility, privacy, and security of health and medical information online. The majority of resident physicians in our institution use Internet and information technology in their practice of medicine. Most think that the Internet will continue to have a beneficial role in the healthcare industry.

Adult↗
PubMed2004

The digital divide phenomenon in a hand surgery outpatient clinic.

The Internet has become an important source of medical information for patients. However, the availability of this resource for individuals in the lower socioeconomic groups is limited, a concept termed the digital divide. To evaluate this phenomenon, we conducted a survey study to quantify the accessibility and use of the Internet for obtaining medical information in an outpatient hand surgery clinic population. A 28-question survey was distributed to 207 patients concerning computer accessibility, Internet use for medical and nonmedical information, Internet trust and security, and patient economic demographics. After analysis of the data, we found individuals in households with higher incomes had a greater likelihood of owning computers than those in lower income brackets. As income increases, the time spent on the Internet also increases. Another statistically significant trend was that higher income patient households thought that Internet information was trustworthy, secure, and private compared with the lower income brackets. We concluded that clinical settings where the predominant patient population earns less than $18,000 may not benefit or use physician Internet-based services or information. The concept of the digital divide seems to be a real phenomenon in the clinical practice of orthopaedics.

Attitude to Computers↗
PubMedDate not supplied

Fibrous dysplasia.

Fibrous dysplasia is a developmental disorder of bone that can present in a monostotic or polyostotic form. Primarily affecting adolescents and young adults, it accounts for 7% of benign bone tumors. Many of the asymptomatic lesions are found incidentally; the remainder present with symptoms of swelling, deformity, or pain. Fibrous dysplasia has been associated with multiple endocrine and nonendocrine disorders and with McCune-Albright and Mazabraud's syndromes. The etiology remains unclear, but molecular biology suggests a mutation in the G(s)alpha subunit and activation of c-fos and other proto-oncogenes. Fibrous dysplasia has a characteristic radiographic appearance. Most cases do not require intervention, but those that do usually are managed surgically with curettage, bone grafting, and, in some cases, internal fixation. When some intervention is necessary but surgery is not practical, treatment is with bisphosphonates. The prognosis generally is good, although poor outcomes are more frequent in younger patients and in those with polyostotic forms of the disease. The risk of malignant transformation is low.

Bone Transplantation↗