Ochsner Journal最新文献

{"title":"Vague Presentation of Cat Scratch Disease in a Child","authors":"Alexander Crowley, B. Desai, Sean Waldron","doi":"10.31486/toj.23.0086","DOIUrl":"https://doi.org/10.31486/toj.23.0086","url":null,"abstract":"","PeriodicalId":47600,"journal":{"name":"Ochsner Journal","volume":"49 8","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139007210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Amelanotic Malignant Melanoma of the Tongue","authors":"Tarun Kumar, Ruchi Sinha, Amber Parwaiz, Madhu Kumari, Tarique Anwer, Surya Nandan Prasad, J. Pandey","doi":"10.31486/toj.23.0094","DOIUrl":"https://doi.org/10.31486/toj.23.0094","url":null,"abstract":"","PeriodicalId":47600,"journal":{"name":"Ochsner Journal","volume":"29 48","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138601784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Zero to Hero? Reducing the Rate of Acute Kidney Injury in Transcatheter Aortic Valve Replacement: The Low Contrast Approach","authors":"Manuel Giraldo-Grueso, Ryan S. Bedi, J. Tafur-Soto, Jasmine Su, Stephen M. Spindel","doi":"10.31486/toj.23.0103","DOIUrl":"https://doi.org/10.31486/toj.23.0103","url":null,"abstract":"","PeriodicalId":47600,"journal":{"name":"Ochsner Journal","volume":"8 11","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138604401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stumped by a Case of Appendicitis After Appendectomy","authors":"Ami Takei Yuen, Anna Suessman","doi":"10.31486/toj.23.0098","DOIUrl":"https://doi.org/10.31486/toj.23.0098","url":null,"abstract":"","PeriodicalId":47600,"journal":{"name":"Ochsner Journal","volume":"24 11","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138602447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patellar Tendon Reconstruction Using Tibialis Posterior Allograft for Treatment of Patellar Tendon Rupture After Bone-Patellar Tendon-Bone Anterior Cruciate Ligament Reconstruction","authors":"MD Andrew Renshaw, MD W. Evans Few, MD Bhumit Desai, MD Brian Godshaw, MD Deryk Jones","doi":"10.31486/toj.23.0104","DOIUrl":"https://doi.org/10.31486/toj.23.0104","url":null,"abstract":"Background: Bone-patellar tendon-bone (BPTB) autografts are often used to treat anterior cruciate ligament (ACL) tears in young, highly active patients. These grafts are robust and provide adequate stability, allowing for return to sport and optimal functional outcomes in athletes. Patellar tendon rupture following BPTB ACL reconstruction is rare and can be difficult to treat. Case Report: A 19-year-old collegiate wrestler injured his left knee during a match. On evaluation 7 days after the injury, he was foundtohaveincreasedanteriortranslationofthetibiaonLachmantestingandanabnormalpivotshift.Magneticresonanceimag-ing demonstrated a complete tear of the ACL, and he successfully underwent a BPTB ACL reconstruction without complication. He progressed appropriately in the acute postoperative period. Six weeks after his index surgery, the patient reinjured his left knee and was diagnosed with a patellar tendon rupture. The previously reconstructed ACL was intact. A posterior tibialis tendon graft was used to repair the patellar tendon via a transosseous tunnel in the tibial tuberosity. The patient’s recovery was complicated by a superficial wound that resolved with treatment. He achieved full range of motion and was able to return to sport. Conclusion: No technique for treating patellar tendon rupture following BPTB ACL reconstruction has been widely accepted. The treatment of this injury is left to the preference of the surgeon. This case demonstrates that tibialis posterior allografts are a viable option for the treatment of such injuries.","PeriodicalId":47600,"journal":{"name":"Ochsner Journal","volume":"26 2","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139268855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-Term Outcomes of Expedited Arthroscopic Tensionable Knotless Biologic Tuberoplasty for Massive Irreparable Rotator Cuff Tears","authors":"Misty Suri, Arjun Verma, Sarena Matriano Lim, Justin Kim, Gregory Parker, Payton Baum, Jordan Nester","doi":"10.31486/toj.23.0063","DOIUrl":"https://doi.org/10.31486/toj.23.0063","url":null,"abstract":"<h3></h3> <b>Background:</b> Massive irreparable rotator cuff tears in the nonarthritic patient are challenging because of the high failure rate and technical difficulty of intraoperative repair. We examined the outcomes of expedited arthroscopic tensionable knotless biologic tuberoplasty for massive irreparable rotator cuff tears. <b>Methods:</b> Eleven patients with an average follow-up of 8.2 months were included in the analysis. Patient-reported outcome measures were the visual analog scale (VAS) pain score, American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) score, Single Assessment Numeric Evaluation (SANE) score, and Veterans RAND 12-Item Health Survey (VR-12) physical component score and mental component score. <b>Results:</b> In comparison to the preoperative mean, mean VAS pain scores were significantly reduced at 2 weeks, 6 weeks, 3 months, 6 months, and 1 year. The mean VAS pain scores decreased from 6.9 ± 1.3 preoperatively to 0.2 ± 0.4 at 1 year (<i>P</i><0.001). Mean ASES scores and SANE scores were both significantly improved at 3 months, 6 months, and 1 year. Mean ASES scores increased from 40.3 ± 17 preoperatively to 93.0 ± 5.5 at 1 year (<i>P</i>=0.001), and mean SANE scores increased from 40.7 ± 23.7 preoperatively to 85.6 ± 8.9 at 1 year (<i>P</i>=0.007). The mean VR-12 physical component score was significantly improved at 6 months and 1 year postoperatively. The mean VR-12 mental component score was clinically improved at 6 months and 1 year postoperatively. <b>Conclusion:</b> Arthroscopic tensionable knotless biologic tuberoplasty is an effective treatment for massive irreparable rotator cuff tears and resulted in statistically significant improvements in VAS pain, ASES, SANE, and the VR-12 physical component scores and clinically significant improvements in the VR-12 mental component score in our patient cohort.","PeriodicalId":47600,"journal":{"name":"Ochsner Journal","volume":"61 13","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134900906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ten Years of a Trans-Pacific Medical Education Partnership—Training Globally to Serve Locally","authors":"G. Dodd Denton, Leonardo Seoane, Diann S. Eley","doi":"10.31486/toj.23.0081","DOIUrl":"https://doi.org/10.31486/toj.23.0081","url":null,"abstract":"<h3></h3> <b>Background:</b> In 2009, Ochsner Health in New Orleans, Louisiana, and The University of Queensland (UQ) in Brisbane, Queensland, Australia, formed a medical school partnership. The rationale for UQ to enter this partnership was to strengthen its already strong international multicultural environment and enrich the domestic Australian student experience. The rationale for Ochsner Health was to raise its academic stature and to train high-quality physicians. This partnership is unique among US international partnerships because the intent is for graduates to practice in the United States. <b>Methods:</b> A new 10-year agreement began in January 2020 with further enhancements to the program. This article describes the educational philosophy informing the partnership, the programmatic design, challenges faced and overcome, and outcomes from the first 10 graduating cohorts of this medical program. <b>Results:</b> The UQ-Ochsner Clinical School partnership posed many challenges. UQ faced a major cultural shift to implement United States Medical Licensing Examination step preparation. Student recruitment challenges and state-specific accreditation concerns had to be solved. The coronavirus disease 2019 pandemic presented unique challenges with the strict prohibition on travel into Australia. Challenges were addressed, and the tenth graduating class completed training in December 2021. More than 850 medical students have graduated from the program, with 30% staying in Louisiana for postgraduate training. The overall first-attempt match rate of 95% exceeds the US allopathic average. Although graduates have faced stigma from their designation as international medical graduates, they have successfully matched in every specialty and in almost every US state. <b>Conclusion:</b> The UQ-Ochsner Clinical School partnership has been successful for the institutions involved and the students who have graduated. The overarching aim of the partnership, “train globally to serve locally,” has endured. Through their training in this partnership, UQ-Ochsner Clinical School graduates bring a unique global outlook to their roles while helping to fill the increasing need for physicians in the United States.","PeriodicalId":47600,"journal":{"name":"Ochsner Journal","volume":"330 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135475576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dyadic Work in Conjunction With Electroconvulsive Therapy in a 12-Year-Old Female With Autism Spectrum Disorder and Catatonia","authors":"Ryan Meeder, Autumn Peterson, Hannah Reynard, Laura Andersen","doi":"10.31486/toj.23.0095","DOIUrl":"https://doi.org/10.31486/toj.23.0095","url":null,"abstract":"Background: Attachment-based interventions have been extensively studied in neurotypical patient populations. In neurodiver-gent patient populations, however, emphasis on and current research into attachment-based interventions are centered on early childhood. Minimal research has been conducted in school-aged children with autism spectrum disorder (ASD), and even less research has focused on attachment-based interventions for children with significant comorbidities such as catatonia. Case Report: We present the case of a 12-year-old female that involved dyadic work in conjunction with biologic interventions for the treatment of ASD and catatonia. Psychosocial interventions were centered on an attachment-based framework and behavioral skills training that incorporated elements of parent management training. We observed and tracked the patient’s unco-operativeness, underproductive speech, emotional withdrawal, and anxiety via the Brief Psychiatric Rating Scale for Children. Attachment-and behavioral-based interventions in conjunction with psychotropic medications and electroconvulsive therapy resulted in improvements. Conclusion: This case illustrates the potential advantages that attachment-and behavioral-based psychotherapeutic interventions can confer in complex cases involving neurodivergent patients. The case also highlights the lack of current research into and understanding of attachment theory in children and adolescents with ASD. Research is needed into the role of attachment-based interventions in patients with ASD and other psychiatric comorbidities, particularly in patient populations beyond preschool age. Initiating nonbiologic interventions in conjunction with biologic interventions may also enhance outcomes and warrants further investigation.","PeriodicalId":47600,"journal":{"name":"Ochsner Journal","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134910253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Allograft in the Load-Bearing Portion of the Femoral Head","authors":"Andrew Renshaw, Nneoma Duru, Eric Assid, Gerard K. Williams, Misty Suri, Deryk Jones","doi":"10.31486/toj.23.0066","DOIUrl":"https://doi.org/10.31486/toj.23.0066","url":null,"abstract":"<h3></h3> <b>Background:</b> An osteochondral defect in the hip can be a painful and limiting pathologic process. The damaged joint may progress into premature osteoarthritis, further limiting a patient9s functionality. <b>Case Report:</b> A 24-year-old male presented to the clinic with left hip pain. The patient had been involved in a motor vehicle accident 3 years prior to presentation to our clinic. His injury from the high-speed accident required intramedullary rod fixation for a right-sided (contralateral) subtrochanteric femur fracture. The patient complained of left groin pain when in a sitting position, with activities of daily living, and with exercise. He failed conservative management consisting of nonsteroidal anti-inflammatory drugs and physical therapy. Imaging on presentation demonstrated an osteochondral defect in the weight-bearing portion of the left femoral head consistent with an International Cartilage Repair Society grade 4b lesion, a cam lesion was noted on assessment of bone morphology, and magnetic resonance imaging revealed degenerative labral pathology. The patient was treated with surgical hip dislocation through a modified Hardinge approach, femoral head osteochondral allograft transplantation using a Missouri Osteochondral Preservation System (MOPS) graft, acetabuloplasty, femoral neck osteoplasty, and open labral repair. <b>Conclusion:</b> Femoral head osteochondral MOPS allograft transplantation is a viable technique for joint preservation in young patients with posttraumatic osteochondral defects of the femoral head.","PeriodicalId":47600,"journal":{"name":"Ochsner Journal","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135590657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venovenous Extracorporeal Membrane Oxygenation Usage Following Bullet Embolism to the Pulmonary Artery","authors":"Jonathan E. Schoen, Brian Carr, Murtuza Ali, Brett Chapman, Alan Marr, Lance Stuke, Patrick Greiffenstein, John P. Hunt, Paige Deville, Alison Smith","doi":"10.31486/toj.23.0027","DOIUrl":"https://doi.org/10.31486/toj.23.0027","url":null,"abstract":"<h3></h3> <b>Background:</b> Pulmonary artery embolus is a rare complication following gunshot wounds that creates a unique and serious challenge for trauma surgeons. While the majority of bullets that embolize through the vascular system end in the peripheral circulation, approximately one-third enter the central venous circulation. <b>Case Report:</b> We present the case of a bullet embolus to the left pulmonary artery following gunshot wounds to the right chest and the abdomen, with the abdominal ballistic traversing the liver before entering the vena cava and embolizing. The patient9s course was complicated by the development of severe acute respiratory distress syndrome that was successfully managed by venovenous extracorporeal membrane oxygenation. <b>Conclusion:</b> Venovenous extracorporeal membrane oxygenation support for severe acute respiratory distress syndrome after bullet embolization to the pulmonary tree and surgical embolectomy is a viable option in appropriately selected patients.","PeriodicalId":47600,"journal":{"name":"Ochsner Journal","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135195391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}