Neurosurgery

Negative Pressure Wound Dressing in the Post Operative Period – a Retrospective Evaluation of its Use in Spine Surgery 2016 -2021

Faculty Mentor’s Name: Dr. Gazanfar Rahmathulla
Email: gazanfar.rahmathulla@jax.ufl.edu
Phone Number: (912) 495-8356
Project Category: Clinical
International Component or Travel: No

Research Project Description:
Overview and background: Negative pressure incisional wound dressings have been used for a number of general surgical procedures, where there is persistent drainage , difficulties in wound closures and healing may take an increased duration. Spinal surgery is well-known for its associated long, painful, and arduous recovery process. Delayed wound healing can result in infections and wound dehiscence requires added costs for treating infections and re-admission for additional procedures.
Changes in technology have created negative pressure incisional therapy that can be applied onto patients spinal wounds following major spinal surgeries on the cervical, thoracic and lumbar spine. We evaluate and compare use of negative pressure incisional dressings as a primary wound dressing modality from 2016-present date and compare them to similar routine wound dressings over this period and will assess wound healing outcomes, short term at 2 weeks and at 30 days and possibly 90 if there are wound healing issues.
We will present the outcomes, advantages, disadvantages and ideal case scenarios for the use of these dressings after data collection and appropriate statistical analysis. Using the data we will also look at the feasibility for inclusion in Enhanced Recovery pathways in spine surgery. Medical student will collect all patient data from UF Jacksonville 2016-date , organize and create an appropriate presentation once completed
Publications of relevance:
1. The Use of Closed Incision Negative-Pressure Wound Therapy in Orthopaedic Surgery. Nam D, Sershon RA, Levine BR, Della Valle CJ.
2.Instillation Negative Pressure Wound Therapy: An Effective Tool for Complex Spine Wounds. West JM, et al. Adv Wound Care (New Rochelle). 2018. PMID: 30374418

Management and Outcomes of Cerebral Vasculopathy in Children with Sickle Cell Disease: a Retrospective Registry

Faculty Mentor’s Name: Dr. Philipp Aldana
Email: Philipp.Aldana@jax.ufl.edu
Phone Number: (904) 633-0991
Project Category: Case Review
International Component or Travel: No

Research Project Description:
Children with sickle cell disease (SCD) are at significant risk for stroke despite best medical management. Cerebral revascularization surgery (CRS) is effective in other diseases in the prevention of stroke due to cerebral vasculopathy, such as Moyamoya syndrome (MMS) – one of the types of vasculopathy seen in SCD. While preliminary studies have shown that these interventions can possibly reduce the risk of stroke in pediatric SCD, they have been mainly single center case series with small sample sizes. The patients identified to be at high risk for stroke have been managed via existing protocols to diagnose them with cerebral vasculopathy and referred for neurosurgical evaluation when appropriate. Following neurosurgical evaluation, surgical intervention may be recommended to the appropriate patient. These interventions can include CRS procedures as well as obliteration of cerebral aneurysms. However, the role of CRS in this patient population is not clearly defined. Thus, this study aims to compare the stroke outcomes in pediatric patients with SCD and MMS following best medical management alone to those additionally undergoing CRS.

As a multi-center, retrospective cohort study, the objective is to determine the role of CRS in this patient population by examining the surgical indications, techniques, outcomes and adverse events of the procedure. Patient characteristics and stroke occurrence will be compared between those who underwent CRS and those who underwent conservative treatment. Medical students would have the opportunity to analyze data and assist with data accuracy of research data between institutions.

Enhancing Metabolic Fitness of T Cells to Treat Brain Cancer

Faculty Mentor’s Name: Dr. Loic Deleyrolle
Email: loic.deleyrolle@neurosurgery.ufl.edu
Phone Number: (352) 682-1961
Project Category: Translational
International Component or Travel: No

Research Project Description:
Adoptive T cell transfer (ACT) has emerged as a viable therapeutic for brain tumors. While promising, the efficacy of this approach is often limited by a complex immunosuppressive tumor microenvironment. These complexities mean that more sophisticated T cell products are necessary for the treatment of such malignancies.
T cell functions are metabolically regulated and undergo metabolic reprogramming upon activation marked by an increased glucose uptake to support their greater bioenergetic and biosynthetic needs. Brain tumors are supported by a microenvironment characterized by tumor-imposed metabolic restrictions with fierce nutrient competition, especially for glucose. We hypothesize that brain tumor cells outcompete adoptively transferred T cells for metabolic substrates like glucose, directly limiting their survival/activation and function.
We propose that by enhancing T cell glucose metabolism through genetic manipulation (overexpression of key glucose transporters) and in vitro metabolic conditioning that we can modulate the metabolic fitness of T cell products and enhance their antitumor efficacy. The effects of these metabolic manipulations will be tested in mouse models of high-grade glioma.

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