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Positive Culture of Atypical Mycobacterium Avium Following Revision Total Knee Arthroplasty. 翻修全膝关节置换术后非典型分枝杆菌培养阳性。
Rhode Island medical journal (2013) Pub Date : 2024-05-02
Jonathan Liu, Jacob Laperche, Marguerite Neill, Derek Jenkins
{"title":"Positive Culture of Atypical Mycobacterium Avium Following Revision Total Knee Arthroplasty.","authors":"Jonathan Liu, Jacob Laperche, Marguerite Neill, Derek Jenkins","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Case: </strong>We report a rare case of mycobacterial periprosthetic joint infection (PJI) after primary total knee arthroplasty 14 years earlier. Progressive knee pain over three years with a negative PJI infectious workup led to revision total knee arthroplasty. A surprising result was isolation of Mycobacterium avium from tissue cultures taken at time of revision surgery. After six months of antibiotic treatment, the patient is alive with well- functioning pain-free TKA at over one-year follow-up.</p><p><strong>Conclusion: </strong>Periprosthetic joint infection can present acutely or chronically years following total knee arthroplasty. Depending on the infecting organism, patients can present with sepsis, or a more indolent slower course that mimics aseptic loosening. In the absence of positive pre-operative labs and cultures, and based on the Musculoskeletal Infection Society (MSIS) criteria, aseptic loosening is a diagnosis of exclusion. An atypical infectious organism should be considered a possible cause and may require specialized cultures of operative specimens.</p>","PeriodicalId":74738,"journal":{"name":"Rhode Island medical journal (2013)","volume":"107 5","pages":"7-10"},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860969","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}
引用次数: 0
Taking the Pulse of the Nursing Home Industry in Rhode Island. 把握罗德岛州养老院行业的脉搏。
Rhode Island medical journal (2013) Pub Date : 2024-05-02
Robert B Hackey, Colleen Dorrian, Meghan Levesque
{"title":"Taking the Pulse of the Nursing Home Industry in Rhode Island.","authors":"Robert B Hackey, Colleen Dorrian, Meghan Levesque","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Nursing home facilities in Rhode Island face unprecedented challenges today. Most facilities find themselves in a difficult financial position with thin - or negative - operating margins. In addition, Rhode Island enacted new minimum staffing regulations for nursing homes in 2021. Facilities that fail to meet the new staffing requirements would incur significant financial penalties. The persistent shortage of direct care staff, however, limits administrators' ability to hire the workers needed to meet the required staffing levels.</p><p><strong>Methods: </strong>We conducted an online survey of nursing home administrators at all of the licensed nursing facilities in Rhode Island over 30 days from September to October 2023. We received responses from 53 out of 77 nursing home administrators, for an overall response rate of 69%.</p><p><strong>Results: </strong>A majority of respondents reported numerous vacancies for clinical staff at their facilities. Most administrators felt that it was difficult to hire new staff, despite a variety of financial incentives to recruit workers. As a result, nursing homes were unable to comply with Rhode Island's new minimum staffing requirements.</p><p><strong>Conclusion: </strong>Nursing homes in Rhode Island continue to experience a chronic staffing shortage. Furthermore, since a majority of nursing homes in Rhode Island have a negative operating margin, enforcing the state's minimum staffing requirements would impose significant financial hardship on the state's nursing facilities.</p>","PeriodicalId":74738,"journal":{"name":"Rhode Island medical journal (2013)","volume":"107 5","pages":"38-42"},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868749","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}
引用次数: 0
Estimating the Effectiveness of COVID-19 Mitigation Policy in Rhode Island. 估算罗德岛 COVID-19 减缓政策的效果。
Rhode Island medical journal (2013) Pub Date : 2024-05-02
John P Fulton, Thomas A Trikalinos, Jonah Popp, Stephanie Pollen, Dana Barclay, Mark Freeman, Maria Messick
{"title":"Estimating the Effectiveness of COVID-19 Mitigation Policy in Rhode Island.","authors":"John P Fulton, Thomas A Trikalinos, Jonah Popp, Stephanie Pollen, Dana Barclay, Mark Freeman, Maria Messick","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74738,"journal":{"name":"Rhode Island medical journal (2013)","volume":"107 5","pages":"55-59"},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871751","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}
引用次数: 0
A Consequence of an Electrical-Burn Injury: Atrial Fibrillation. 电烧伤的后果：心房颤动
Rhode Island medical journal (2013) Pub Date : 2024-05-02
Anita Knopov, Giovanna Deluca, Tareq Kheirbek, Nicholas J Musisca
{"title":"A Consequence of an Electrical-Burn Injury: Atrial Fibrillation.","authors":"Anita Knopov, Giovanna Deluca, Tareq Kheirbek, Nicholas J Musisca","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cardiac arrhythmias following electrocution injuries can accompany high-voltage or high- intensity currents. Contributing factors to electrical hazard are the type of current, voltage, resistance, and duration of contact and pathway through the body. It is important to monitor for delayed arrhythmias in patients with an electrical injury. We describe a case of a 52-year-old man who presented after an electrical shock injury while grabbing a 5,000-voltage wire at work. In this case report, we discuss the presentation, management, and follow-up recommendations for this type of injury.</p>","PeriodicalId":74738,"journal":{"name":"Rhode Island medical journal (2013)","volume":"107 5","pages":"18-20"},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873879","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}
引用次数: 0
Ebstein's Anomaly of the Tricuspid Valve. 三尖瓣埃布斯坦氏异常。
Rhode Island medical journal (2013) Pub Date : 2024-05-02
Beatriz Rizkallah Alves, Carolina Saldanha Neves Horta Lima, Somwail Rasla
{"title":"Ebstein's Anomaly of the Tricuspid Valve.","authors":"Beatriz Rizkallah Alves, Carolina Saldanha Neves Horta Lima, Somwail Rasla","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74738,"journal":{"name":"Rhode Island medical journal (2013)","volume":"107 5","pages":"21-24"},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869612","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}
引用次数: 0
Refractory Hypoglycemia Due to Sulfonylurea Contamination of Illicit Opioid Medications. 非法阿片类药物磺酰脲类污染导致的难治性低血糖症。
Rhode Island medical journal (2013) Pub Date : 2024-05-02
Jeffrey R Savarino, Robert Mokszycki, Robert Tubbs, Rachel S Wightman
{"title":"Refractory Hypoglycemia Due to Sulfonylurea Contamination of Illicit Opioid Medications.","authors":"Jeffrey R Savarino, Robert Mokszycki, Robert Tubbs, Rachel S Wightman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Illicit drug supply adulteration can heighten the risk for adverse health outcomes. Sulfonylurea medications are widely used in the treatment of diabetes mellitus (DM). Unintentional or intentional overdose of sulfonylureas can cause refractory hypoglycemia. This case report describes a 62-year-old male patient who presented to the emergency department (ED) after being found on the ground with signs of mild trauma. He was noted to be persistently hypoglycemic despite boluses of intravenous dextrose, a dextrose infusion, and oral nutrition. The patient did report purchase and oral ingestion of pills sold as oxycodone and that the pill shape and color were different from his usual supply. The patient was empirically treated with octreotide resulting in normalization of his serum glucose. Testing demonstrated a serum glipizide concentration six times the reporting range. This case represents unintentional sulfonylurea exposure in the setting of non-prescribed oxycodone use, resulting in hypoglycemia refractory to intravenous dextrose and oral nutrition. Octreotide is an additional potential treatment for this condition. As in this case, ingestion of street drugs may present a potential source of sulfonylurea exposure. Opioid contamination with sulfonylureas has not been widely reported in the literature and knowledge about this potential exposure is important for the prompt recognition and treatment of these patients by emergency physicians.</p>","PeriodicalId":74738,"journal":{"name":"Rhode Island medical journal (2013)","volume":"107 5","pages":"11-13"},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872621","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}
引用次数: 0
Urothelial Carcinoma: Epidemiology and Imaging-Based Review. 尿路上皮癌：流行病学和影像学回顾。
Rhode Island medical journal (2013) Pub Date : 2024-05-02
Ashwin C Reddy, Joey Z Gu, Brandon H Koo, Victoria Fruh, Alessandra J Sax
{"title":"Urothelial Carcinoma: Epidemiology and Imaging-Based Review.","authors":"Ashwin C Reddy, Joey Z Gu, Brandon H Koo, Victoria Fruh, Alessandra J Sax","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Bladder cancer is the 6th most common malignancy in the United States, with urothelial carcinomas comprising over 95% of cases of bladder cancer, and commands a significant disease burden in Rhode Island. Imaging studies can provide valuable diagnostic information for urothelial carcinomas at initial presentation and are routinely used for noninvasive staging, treatment response monitoring, and post-treatment surveillance. This review aims to discuss and highlight three imaging modalities: ultrasonography, computed tomography, and magnetic resonance imaging, with particular focus on the notable features and appearance of urothelial carcinoma on each modality and their relative utility throughout the disease course. A general overview of disease epidemiology and treatment practices is also provided.</p>","PeriodicalId":74738,"journal":{"name":"Rhode Island medical journal (2013)","volume":"107 5","pages":"26-32"},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872370","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}
引用次数: 0
Common Peroneal Nerve and Tarsal Tunnel Release Surgery in an Adolescent Male with Hunter Syndrome: Illustrative Case. 一名患有亨特综合征的青少年男性的腓总神经和跗骨隧道松解手术：示例病例。
Rhode Island medical journal (2013) Pub Date : 2024-05-02
Elijah M Persad-Paisley, Belinda Shao, Vinay Rao, Loree K Kalliainen
{"title":"Common Peroneal Nerve and Tarsal Tunnel Release Surgery in an Adolescent Male with Hunter Syndrome: Illustrative Case.","authors":"Elijah M Persad-Paisley, Belinda Shao, Vinay Rao, Loree K Kalliainen","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Children with Hunter syndrome have a high prevalence of nerve compression syndromes given the buildup of glycosaminoglycans in the tendon sheaths and soft tissue structures. These are often comorbid with orthopedic conditions given joint and tendon contractures due to the same pathology. While carpal tunnel syndrome and surgical treatment has been well-reported in this population, the literature on lower extremity nerve compression syndromes and their treatment in Hunter syndrome is sparse.</p><p><strong>Observations: </strong>We report the case of a 13-year-old male with a history of Hunter syndrome who presented with toe-walking and tenderness over the peroneal and tarsal tunnel areas. He underwent bilateral common peroneal nerve and tarsal tunnel releases, with findings of severe nerve compression and hypertrophied soft tissue structures demonstrating fibromuscular scarring on pathology. Post-operatively, the patient's family reported subjective improvement in lower extremity mobility and plantar flexion.</p><p><strong>Lessons: </strong>In this case, peroneal and tarsal nerve compression were diagnosed clinically and treated effectively with surgical release and postoperative ankle casting. Given the wide differential of common comorbid orthopedic conditions in Hunter syndrome and the lack of validated electrodiagnostic normative values in this population, the history and physical examination and consideration of nerve compression syndromes are tantamount for successful workup and treatment of gait abnormalities in the child with Hunter syndrome.</p>","PeriodicalId":74738,"journal":{"name":"Rhode Island medical journal (2013)","volume":"107 5","pages":"14-17"},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867022","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}
引用次数: 0
Assessing the Trends of Tramadol Utilization in the Medicare Part D Population in Rhode Island. 评估罗德岛州医疗保险 D 部分人群使用曲马多的趋势。
Rhode Island medical journal (2013) Pub Date : 2024-05-02
Eric P Borrelli
{"title":"Assessing the Trends of Tramadol Utilization in the Medicare Part D Population in Rhode Island.","authors":"Eric P Borrelli","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To assess the trends in tramadol dispensing among Medicare Part D patients in Rhode Island.</p><p><strong>Methods: </strong>An analysis was conducted of the Medicare Part D Provider Utilization and Payment Data Public Use File for the years 2013-2021. Chi squared tests were conducted to assess statistical significance of annual changes in proportions.</p><p><strong>Results: </strong>Following tramadol becoming a controlled substance in 2014, the number of dispensed tramadol prescriptions and patients with a tramadol prescription decreased every subsequent year through 2021 (prescriptions: 42,157 to 33,026; patients: 12,654 to 9,653). The percentage of opioid prescriptions that were tramadol increased from 16.32% in 2013 to 21.19% in 2020.</p><p><strong>Conclusion: </strong>Tramadol utilization has been decreasing among the Medicare Part D population in Rhode Island while the percentage of opioid dispensings that were tramadol have been increasing. Future studies are needed to assess whether patients utilizing tramadol are at a higher risk for adverse outcomes.</p>","PeriodicalId":74738,"journal":{"name":"Rhode Island medical journal (2013)","volume":"107 5","pages":"33-37"},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869217","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}
引用次数: 0
Cholangiocarcinoma: Epidemiology and Imaging-Based Review. 胆管癌：流行病学和影像学回顾。
Rhode Island medical journal (2013) Pub Date : 2024-05-02
Simon Kidanemariam, Joey Gu, Jessica H Yoon, Jothika V Challapalli, Victoria Fruh, Alessandra J Sax
{"title":"Cholangiocarcinoma: Epidemiology and Imaging-Based Review.","authors":"Simon Kidanemariam, Joey Gu, Jessica H Yoon, Jothika V Challapalli, Victoria Fruh, Alessandra J Sax","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cholangiocarcinoma (CCA) is a rare cancer of the bile duct epithelium, and in the last few decades its incidence rate has been increasing. It is associated with a high mortality rate due to late diagnosis and its aggressive nature. Many risk factors have been identified; some are more common in certain regions than others. CCA can be classified according to its anatomical location or macroscopic growth pattern, the latter being most helpful for imaging interpretation. Clinical features can vary from obstructive-like symptoms to nonspecific symptoms, such as weight loss and malaise. Imaging, specifically MRI/MRCP, is crucial in diagnosing CCA, staging, and treatment planning. Surgery with chemotherapy is the mainstay treatment option, and other palliative treatment options exist for those who have unresectable disease.</p>","PeriodicalId":74738,"journal":{"name":"Rhode Island medical journal (2013)","volume":"107 5","pages":"43-48"},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140863871","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}
引用次数: 0
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