Ochsner Journal最新文献_第5页

Risk of Instrumental Delivery in Maternal Obesity: Estimates With Measures of Effect Size. 产妇肥胖的器质性分娩风险：效应大小的估计值。

IF 1.3

Ochsner Journal Pub Date : 2024-01-01 DOI: 10.31486/toj.24.0041

Melinda Chai, Amanda Vining, Joseph Koveleskie, William Sumrall, Bobby D Nossaman

{"title":"Risk of Instrumental Delivery in Maternal Obesity: Estimates With Measures of Effect Size.","authors":"Melinda Chai, Amanda Vining, Joseph Koveleskie, William Sumrall, Bobby D Nossaman","doi":"10.31486/toj.24.0041","DOIUrl":"https://doi.org/10.31486/toj.24.0041","url":null,"abstract":"Background: Obesity, defined as a body mass index ≥30 kg/m2, is epidemic in the United States and is associated with increased risks of adverse events. Studies have examined the role of maternal obesity on the incidence of instrumental vaginal delivery, but the results are divided. However, these analyses used frequentist tests that risk false discovery. The purpose of this retrospective study was to quantify the association of maternal obesity to the need for instrumental delivery with measures of effect size. Measures of effect size allow assessment of the impact of clinical risk factors on outcomes of interest. Methods: All parturients aged ≥18 years in active labor at our facility from January 2018 to May 2019 were entered into this study. Patient demographics, previously reported comorbidities, and obstetric parameters were collected and analyzed to determine the clinical impact of maternal obesity on the incidence of instrumental delivery. One effect size measure, risk differences, was used to quantify the clinical effect of maternal obesity on the need for instrumental delivery. A generalized linear model was used to standardize the measures of effect size of previously reported comorbidities, including maternal obesity, and to determine their association with the need for instrumental delivery. Results: The incidences of chronic and gestational hypertension, preeclampsia, chronic diabetes, and reactive airway disease were higher in parturients with maternal obesity. Risk differences due to maternal obesity were observed in parturients presenting with shoulder dystocia but not in those who underwent oxytocin induction or in nulliparous parturients. Following regression analysis, maternal obesity did not clinically impact the need for instrumental delivery. Conclusion: These findings suggest that maternal obesity did not have a clinical impact on the need for instrumental delivery.","PeriodicalId":47600,"journal":{"name":"Ochsner Journal","volume":"24 3","pages":"192-197"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11398620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rare Prekallikrein Deficiency Identified During Workup of Isolated Prolonged Activated Partial Thromboplastin Time. 在分离的活化的部分凝血活素时间延长的检查中发现罕见的预钾激肽缺乏症。

IF 1.3

Ochsner Journal Pub Date : 2024-01-01 DOI: 10.31486/toj.24.0046

Jennifer S Woo, Jennifer Tseng, Irene M Kang, Lefan Zhuang, Ryan Jackson, Olga V Danilova, Azra Borogovac

{"title":"Rare Prekallikrein Deficiency Identified During Workup of Isolated Prolonged Activated Partial Thromboplastin Time.","authors":"Jennifer S Woo, Jennifer Tseng, Irene M Kang, Lefan Zhuang, Ryan Jackson, Olga V Danilova, Azra Borogovac","doi":"10.31486/toj.24.0046","DOIUrl":"10.31486/toj.24.0046","url":null,"abstract":"Background: Prolongation of the activated partial thromboplastin time (aPTT) may signify an intrinsic factor deficiency or the presence of an inhibitor of coagulation, potentially placing a patient at increased risk for bleeding. However, a contact factor (ie, factor XII, prekallikrein, and high molecular weight kininogen) deficiency, which may also cause a prolonged aPTT, is not associated with clinical bleeding. Case Report: A 71-year-old female had an isolated prolonged aPTT discovered during preoperative laboratory testing. Results of the initial coagulation tests demonstrated no deficiency of factors VIII, IX, or XI and no evidence for lupus anticoagulant or antiphospholipid antibodies. However, a mixing study test was suggestive of factor deficiency. Based on these results, contact factor activity tests were performed to identify any contact factor deficiency. The patient was determined to have a prekallikrein deficiency. Conclusion: Rare causes of isolated prolonged aPTT include contact factor deficiencies such as prekallikrein deficiency. Identification of a contact factor deficiency is clinically useful information, as it allows for a definitive assessment of bleeding risk. This case reports a rare factor deficiency and illustrates a contemporary approach to the workup of an isolated prolonged aPTT.","PeriodicalId":47600,"journal":{"name":"Ochsner Journal","volume":"24 4","pages":"309-313"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Novel Treatment for a Completely Extruded Talus. 距骨完全挤压的新治疗方法。

IF 1.3

Ochsner Journal Pub Date : 2024-01-01 DOI: 10.31486/toj.24.0047

Basel Taha, Colin Carroll, Rick Gehlert

{"title":"Novel Treatment for a Completely Extruded Talus.","authors":"Basel Taha, Colin Carroll, Rick Gehlert","doi":"10.31486/toj.24.0047","DOIUrl":"10.31486/toj.24.0047","url":null,"abstract":"Background: Complete talar extrusion is a rare injury that is typically caused by high-energy impact. Treatment for a completely extruded talus is limited and has variable outcomes and complications. Tibiocalcaneal arthrodesis is one of the best treatments for restoring stability and reducing pain in the affected limb. Case Report: A 52-year-old male had complete talar extrusion after a pedestrian vs vehicle accident, and his recovery was complicated by wound dehiscence and recurrent infections of the ankle. Three years after his original injury, the patient was treated with a tibiocalcaneal arthrodesis with tantalum metal cone spacer, autologous bone grafting with tibial reamer irrigator aspirator, and retrograde hindfoot nail. The fusion healed well without signs of nonunion. Following wound healing and recovery, the patient was able to ambulate without any assistive devices. Conclusion: To our knowledge, our case is the first report of the use of a metal spacer in conjunction with autologous bone grafting multiple years after an initial complete talar extrusion injury. The patient's novel treatment resulted in good postoperative outcomes, including significant improvement in pain, ankle stability, and independent ambulation.","PeriodicalId":47600,"journal":{"name":"Ochsner Journal","volume":"24 4","pages":"314-317"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Training Cerebrovascular and Neuroendovascular Surgery Residents: A Systematic Literature Review and Recommendations. 培训脑血管和神经内血管外科住院医生：系统性文献综述和建议。

IF 1.2

Ochsner Journal Pub Date : 2024-01-01 DOI: 10.31486/toj.23.0118

Tyler Scullen, James Milburn, Mansour Mathkour, Angela Larrota, Oluyinka Aduloju, Aaron Dumont, John Nerva, Peter Amenta, Arthur Wang

{"title":"Training Cerebrovascular and Neuroendovascular Surgery Residents: A Systematic Literature Review and Recommendations.","authors":"Tyler Scullen, James Milburn, Mansour Mathkour, Angela Larrota, Oluyinka Aduloju, Aaron Dumont, John Nerva, Peter Amenta, Arthur Wang","doi":"10.31486/toj.23.0118","DOIUrl":"10.31486/toj.23.0118","url":null,"abstract":"Background: The rapid evolution of neuroendovascular intervention has resulted in the inclusion of endovascular techniques as a core competency in neurosurgical residency training. Methods: We conducted a literature review of studies involving the training of neurosurgical residents in cerebrovascular and endovascular neurosurgery. We reviewed the evolution of cerebrovascular neurosurgery and the effects of these changes on residency, and we propose interventions to supplement contemporary training. Results: A total of 48 studies were included for full review. Studies evaluated trainee education and competency (29.2%, 14/48), neuroendovascular training models (20.8%, 10/48), and open cerebrovascular training models (52.1%, 25/48), with some overlap. We used a qualitative analysis of reviewed reports to generate a series of suggested training supplements to optimize cerebrovascular education. Conclusion: Cerebrovascular neurosurgery is at a crossroads where trainees must develop disparate skill sets with inverse trends in volume. Continued longitudinal exposure to both endovascular and open cerebrovascular surgical fields should be mandated in general resident education, and blended learning tactics using adjunct simulation systems and models should be incorporated with didactics to both optimize learning and alleviate restraints placed by decreased volume and autonomy.","PeriodicalId":47600,"journal":{"name":"Ochsner Journal","volume":"24 1","pages":"36-46"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10949058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Electronic Vapor Products: Alarming Trends in United States Adolescents. 电子蒸汽产品：美国青少年中令人担忧的趋势。

IF 1.3

Ochsner Journal Pub Date : 2024-01-01 DOI: 10.31486/toj.24.0004

Charles H Hennekens, Adedamola Adele, Maria C Mejia, Robert S Levine, Panagiota Kitsantas

{"title":"Electronic Vapor Products: Alarming Trends in United States Adolescents.","authors":"Charles H Hennekens, Adedamola Adele, Maria C Mejia, Robert S Levine, Panagiota Kitsantas","doi":"10.31486/toj.24.0004","DOIUrl":"10.31486/toj.24.0004","url":null,"abstract":"Background: The use of electronic vapor products (EVPs) increases the risks of nicotine addiction, drug-seeking behavior, mood disorders, and avoidable premature morbidities and mortality. We explored temporal trends in EVP use among US adolescents. Methods: We used data from the Youth Risk Behavior Survey for school grades 9 through 12 from 2015 (earliest available data) to 2021 (the most recently available data) from the US Centers for Disease Control and Prevention (n=57,006). Results: Daily use of EVPs increased from 2.0% in 2015 to 7.2% in 2019, a greater than 3.5-fold increase. Although the percentage decreased to 5.0% in 2021, it was still a >2.5-fold increase since 2015. In 2015, the percentage of EVP use was significantly higher in boys (2.8%) than girls (1.1%). By 2021, the percentage of EVP use was higher in girls (5.6%) than boys (4.5%), a 1.24-fold increase. In addition, the percentage of EVP use in 2021 was higher in White youth (6.5%) vs Black (3.1%), Asian (1.2%), and Hispanic/Latino (3.4%) youth compared to 2015, but White and Black adolescents had the highest increases of approximately 3.0-fold between 2015 and 2021. Adolescents in grade 12 had the highest percentages of EVP use at all periods. Conclusion: These data show alarming statistically significant and clinically important increases in EVP use in US adolescents in school grades 9 through 12. The magnitude of the increases may have been blunted by coronavirus disease 2019, a hypothesis that requires direct testing in analytic studies. These trends create clinical and public health challenges that require targeted interventions such as mass media campaigns and peer interventions to combat the influences of social norms that promote the adoption of risky health behaviors during adolescence.","PeriodicalId":47600,"journal":{"name":"Ochsner Journal","volume":"24 2","pages":"103-107"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11192225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparative, Controlled, Retrospective Study of Patient-Reported Outcomes After Meniscectomy With Adjunctive Use of Platelet-Rich Plasma or Amniotic Umbilical Cord Tissue 半月板切除术后辅助使用富血小板血浆或羊膜脐带组织的患者报告结果比较、对照、回顾性研究

IF 1.2

Ochsner Journal Pub Date : 2023-12-28 DOI: 10.31486/toj.23.0073

N. Duru, Gerard K. Williams, Eric Assid, Andrew Renshaw, Deryk Jones