Spartan medical research journal最新文献_第10页

Management of Lateral Thigh Pain following Cephalomedullary Nail: A Technical Note. 头髓内钉后大腿外侧疼痛的治疗：一项技术注意事项。

Spartan medical research journal Pub Date : 2020-06-08

Michael Rosen, Connor Kasik, Michael Swords

{"title":"Management of Lateral Thigh Pain following Cephalomedullary Nail: A Technical Note.","authors":"Michael Rosen, Connor Kasik, Michael Swords","doi":"","DOIUrl":"","url":null,"abstract":"Peritrochanteric hip fractures are most commonly treated with proximal femoral fixation devices, such as a cephalomedullary nail or sliding hip screw. As usage rates increase for these fixation devices, complications from their insertion are becoming more prevalent. Lateral hip pain from proximal locking device insertion and prominence continues to be one of the most frequent complaints regarding hardware irritation following this surgical procedure. Conservative treatment options for this complaint include local corticosteroid injection and physical therapy, although once these treatments have been exhausted, surgical intervention may be recommended. This has generally been managed previously with implant removal, although studies have shown associated femoral neck fractures after removal even with the prescribed protected postoperative weight bearing. Additionally, in certain situations (e.g., when the nail is placed for prophylactic treatment), its removal is contraindicated. The purpose of this manuscript is to describe an alternative treatment option that would limit morbidity, and the need for proximal locking device or implant removal by excising the portion of the iliotibial band causing hip irritation at the level of the proximal locking device, while leaving the retained implant in place. This surgical option would allow most patients to return to their pre-operative weight-bearing status immediately following surgery without the need for additional postoperative precautions.","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"5 1","pages":"12931"},"PeriodicalIF":0.0,"publicationDate":"2020-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41184450","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

Congenital Pharyngeal Web in an Adult: Treatment of a Rare Clinical Anomaly by Coblation. 成人先天性咽喉网：通过钴化治疗一种罕见的临床异常。

Spartan medical research journal Pub Date : 2020-06-08

Katrina Minutello, Steven Pinther, Robert Stachler

{"title":"Congenital Pharyngeal Web in an Adult: Treatment of a Rare Clinical Anomaly by Coblation.","authors":"Katrina Minutello, Steven Pinther, Robert Stachler","doi":"","DOIUrl":"","url":null,"abstract":"Introduction to the topic: Previous reports of congenital pharyngeal webs, although rare, have been described in children. Clinical presentation varies, ranging from aspiration to intermittent airway obstruction, and most commonly, dysphagia. In this case report, the authors describe an unusual finding of a hypopharyngeal web in an adult patient. This patient had no prior history of chemoradiotherapy, malignancy, or total laryngectomy, all of which have been associated with acquired pharyngeal stenosis, supporting that this finding was of congenital origin. After a review of the possible embryological developmental abnormalities, the hypothesis is that of gut recanalization failure during development.Case presentation: We present a case of a woman in her mid-40's with a history of solid food dysphagia resulting in a 20 kg weight loss over three months. The patient denied dysphagia progressing to liquids, pain with swallowing, and a history of alcohol or tobacco use. Upon examination of the larynx via laryngoscope, a congenital hypopharyngeal web was identified. Successful excision of the web via coblation restored proper drainage of the pyriform sinus into the esophagus and resulted in markedly improved swallowing function and weight gain.Conclusions: Pharyngeal webs are rare findings, particularly in adult patients. These congenital anomalies can be safely and effectively treated endoscopically via coblation.","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":" ","pages":"12473"},"PeriodicalIF":0.0,"publicationDate":"2020-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25424505","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

Incidence of Heterotopic Ossification in Direct Anterior Approach to Total Hip Arthroplasty with use of Aspirin as Thromboembolic Prophylaxis 使用阿司匹林预防血栓栓塞的全髋关节置换术直接前路异位骨化的发生率

Spartan medical research journal Pub Date : 2020-06-08 DOI: 10.51894/001c.12263

P. Knapp, Ross Doehrmann, S. Yokhana, Syed Rizvi, J. Boura, David Knesek

{"title":"Incidence of Heterotopic Ossification in Direct Anterior Approach to Total Hip Arthroplasty with use of Aspirin as Thromboembolic Prophylaxis","authors":"P. Knapp, Ross Doehrmann, S. Yokhana, Syed Rizvi, J. Boura, David Knesek","doi":"10.51894/001c.12263","DOIUrl":"https://doi.org/10.51894/001c.12263","url":null,"abstract":"CONTEXT Heterotopic ossification (H.O.) is a common occurrence after total hip arthroplasty (THA) with significant potential clinical ramifications. Controversy still exists regarding the exact etiology of the disorder, including possible risk factors. Surgical technique, surgical approach, postoperative medication protocols and even thromboembolic prophylaxis have been implicated in the formation of H.O. Our study looked at one institution with a single surgeon performing direct anterior THA (DAA THA) in patients who received aspirin (ASA) as monotherapy for thromboembolic prophylaxis. METHODS Patients at a single institution who underwent DAA THA between 2015 and 2019 were identified by CPT code. 45 patients ultimately met inclusion criteria. Postoperative radiographs were analyzed retrospectively for H.O. according to the Brooker classification. Several patient characteristics and comorbidities were statistically analyzed using Chi-square tests, Fisher Exact tests, Wilcox rank sum tests, and Pearson correlation. RESULTS 12 patients (26.7%) were found to have heterotopic ossification (67% Class 1, 8% Class 2, 25% Class 3, and 0% Class 4); with a median follow up of 35 weeks (range: 12-96). 25% of these patients received ASA 325mg BID while 75% received ASA 81 BID. No statistical differences in development of H.O. were detected among age, gender, BMI, sex, race, diabetes, or NSAID use in the post-operative interval. There were significantly more smokers in the H.O. group (50% vs. 9%, p<0.006). CONCLUSIONS Our analysis aimed to quantify the incidence of H.O. with consistency in surgical approach and post-operative protocol. There have been few studies on this topic, and we believe it is very relevant with the increasing use of aspirin in the post-operative protocol for thromboembolic prophylaxis. Our retrospective analysis identified H.O. at rates similar to previous studies in DAA.","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42932670","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: 1

Management of Lateral Thigh Pain following Cephalomedullary Nail: A Technical Note 头髓钉后大腿外侧疼痛的处理:技术说明

Spartan medical research journal Pub Date : 2020-06-08 DOI: 10.51894/001c.12931

M. Rosen, Connor S Kasik, M. Swords

{"title":"Management of Lateral Thigh Pain following Cephalomedullary Nail: A Technical Note","authors":"M. Rosen, Connor S Kasik, M. Swords","doi":"10.51894/001c.12931","DOIUrl":"https://doi.org/10.51894/001c.12931","url":null,"abstract":"Peritrochanteric hip fractures are most commonly treated with proximal femoral fixation devices, such as a cephalomedullary nail or sliding hip screw. As usage rates increase for these fixation devices, complications from their insertion are becoming more prevalent. Lateral hip pain from proximal locking device insertion and prominence continues to be one of the most frequent complaints regarding hardware irritation following this surgical procedure. Conservative treatment options for this complaint include local corticosteroid injection and physical therapy, although once these treatments have been exhausted, surgical intervention may be recommended. This has generally been managed previously with implant removal, although studies have shown associated femoral neck fractures after removal even with the prescribed protected postoperative weight bearing. Additionally, in certain situations (e.g., when the nail is placed for prophylactic treatment), its removal is contraindicated. The purpose of this manuscript is to describe an alternative treatment option that would limit morbidity, and the need for proximal locking device or implant removal by excising the portion of the iliotibial band causing hip irritation at the level of the proximal locking device, while leaving the retained implant in place. This surgical option would allow most patients to return to their pre-operative weight-bearing status immediately following surgery without the need for additional postoperative precautions.","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44826485","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: 3

Removal of Ioban May Pull Bacteria to the Surface of the Skin: Lessons Learned. 移除伊班可能将细菌带到皮肤表面：经验教训。

Spartan medical research journal Pub Date : 2020-06-08

Jacob Lytle, Jordan McCoy, Katie Smeltzer, Ryan Nelson

{"title":"Removal of Ioban May Pull Bacteria to the Surface of the Skin: Lessons Learned.","authors":"Jacob Lytle, Jordan McCoy, Katie Smeltzer, Ryan Nelson","doi":"","DOIUrl":"","url":null,"abstract":"Context: Cutibacterium acnes (C. Acnes, formerly known as Propionibacterium acnes) are slow growing, gram positive, anaerobic bacilli. C. acnes are found in many locations, both as part of normal skin flora, as well as a contaminant of environmental surfaces. These bacteria have been associated with prosthetic joint infections of the shoulder, and it has been challenging to prevent such infections for a variety of reasons. The purpose of this quality improvement project was to investigate whether the surgical adhesive dressing Ioban could pull subcutaneous C. acnes bacteria from the surgical field.Methods: During this quality improvement project, a convenience sample of 16 adult volunteers were gathered from other residency departments and from medical students at our hospital. The volunteers were used to take samples from two sites on each shoulder. The shoulder sites were prepped and covered with iodine-impregnated dressings.Results: There were 26 of 64 (40.6%) samples in the no Ioban group that grew C. acnes. The Ioban group had 37 of 64 (57.8%) samples found to be positive for C. acnes growth. During this project, we identified several key points that could be useful to future researchers working in community hospitals. We describe these lessons concerning ongoing communication with lab and research departments, offering volunteers compensation to participate, interacting with departments unaccustomed to research, and development of a clear methodology.Conclusions: This was the first time our department had conduct a project utilizing the laboratory as well as volunteers. This came with unforeseen challenges which caused significant time delays. We believe that by highlighting these lessons for future researchers, they might avoid such problems during project activities.","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":" ","pages":"12463"},"PeriodicalIF":0.0,"publicationDate":"2020-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25424504","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

Provider Driven Follow-Up in a Chest Pain Accelerated Diagnostic Protocol: Round Two of the PDSA Cycle in a Multidisciplinary Quality Improvement Patient Safety Project. 胸痛加速诊断方案中由提供者驱动的随访：多学科质量改进患者安全项目中的 PDSA 循环第二轮。

Spartan medical research journal Pub Date : 2020-01-30

Isaac Troiano, Mary Mitchell, Mark Schury, Nikolai Butki

{"title":"Provider Driven Follow-Up in a Chest Pain Accelerated Diagnostic Protocol: Round Two of the PDSA Cycle in a Multidisciplinary Quality Improvement Patient Safety Project.","authors":"Isaac Troiano, Mary Mitchell, Mark Schury, Nikolai Butki","doi":"","DOIUrl":"","url":null,"abstract":"Context: In 2016, the McLaren Oakland Department of Emergency Medicine developed and implemented a Chest Pain Accelerated Diagnostic Protocol (CP-ADP) to identify patients presenting to the emergency department (ED) with chest pain who were at low risk for acute coronary syndrome (ACS) and appropriate for outpatient follow-up. The evaluation of the QI/PS project demonstrated that only 47% of the patients discharged from the ED under the CP-ADP received outpatient follow-up. In response, a second round of the PDSA cycle modified the CP-ADP to add a multidisciplinary provider driven follow-up.Methods: After ED discharge, patients in the CP-ADP with provider driven follow-up were contacted by a primary care physician to schedule a follow-up appointment. The premise was that this provider driven follow-up would alleviate navigation of the health care system as a barrier to follow-up.Results: The evaluation of the modified CP-ADP with provider driven follow-up demonstrated that 9 of the 30 patients discharged from the ED were able to be contacted. 21 of the patients were unable to be reached by the phone number they provided. Only 3 patients discharged with provider driven follow-up showed up to follow up appointments.Conclusions: There were some internal process failures identified that contributed to the low numbers of patients that were successfully contacted. External factors such as patient access to phones and means of communication were also discussed as factors that were originally not considered.","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"4 2","pages":"11727"},"PeriodicalIF":0.0,"publicationDate":"2020-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25424500","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

Laryngeal Burn from a Sweet Potato: A Case Report. 红薯引起的喉部烧伤：病例报告

Spartan medical research journal Pub Date : 2020-01-30

Steven Pinther, Juliana Codino, Adam Rubin

引用次数: 0

Straw vs Cup Use in Patients with Symptoms of Oropharyngeal Dysphagia. 有口咽吞咽困难症状的患者使用吸管与杯子。

Spartan medical research journal Pub Date : 2020-01-30

Bo Pang, Paul Cox, Julianna Codino, Austin Collum, Jake Sims, Adam Rubin

{"title":"Straw vs Cup Use in Patients with Symptoms of Oropharyngeal Dysphagia.","authors":"Bo Pang, Paul Cox, Julianna Codino, Austin Collum, Jake Sims, Adam Rubin","doi":"","DOIUrl":"","url":null,"abstract":"Context: This study aims to determine whether straw or cup use is superior for the control of a single thin liquid bolus in patients with symptoms of oropharyngeal dysphagia to liquids.Methods: This is a prospective, randomized, single-blinded study. Patients were studied at a Professional Voice and Swallowing Center by a laryngologist between April 2017 and April 2018. Twenty-five patients, 18 years of age or older, who presented with symptoms of oropharyngeal dysphagia the clinic were included in the study. Each patient complained of difficulty with choking on liquids. Informed consent was obtained from each patient. Patients that were unable to follow one to two step commands and patients with dysphagia that lack oral strength or respiratory strength to facilitate straw or cup usage were not included. Patients with dysphagia that are tracheostomy tube dependent were also not included.Results: The average PAS for straw versus cup drinking at 10mL was 1.08 and 1.04 respectively with a p-value of 0.33. For straw versus cup at 20mL, the PAS was 1.04 and 1.26 respectively with a p-value of 0.13. For 30mL, the PAS was 1.0 and 1.4 for straw and cup use respectively with a p-value of 0.16. And for 40mL, the PAS was 1.0 and 1.09 with a p-value of 0.27.Conclusions: No statistical significant difference was demonstrated in risk of penetration or aspiration of thin liquids between cup and straw usage in patients with mild oropharyngeal dysphagia.","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"4 2","pages":"11591"},"PeriodicalIF":0.0,"publicationDate":"2020-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41184455","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

Disordered Eating and Eating Disorders in Adolescent Athletes 青少年运动员饮食失调

Spartan medical research journal Pub Date : 2020-01-30 DOI: 10.51894/001c.11595

Ryley Mancine, S. Kennedy, P. Stephan, A. Ley

{"title":"Disordered Eating and Eating Disorders in Adolescent Athletes","authors":"Ryley Mancine, S. Kennedy, P. Stephan, A. Ley","doi":"10.51894/001c.11595","DOIUrl":"https://doi.org/10.51894/001c.11595","url":null,"abstract":"CONTEXT To summarize available literature to date and discuss the importance of Disordered Eating (DE) in adolescent athletes, with special attention to the female athlete triad. In this paper, the authors will review the literature regarding adolescent athletes who intentionally engage in abnormal eating behaviors and focus on adolescent athletes of all training levels who may be affected by both DE and eating disorders (ED). METHODS In 2019, the authors completed a systematic literature search on PubMed using the search term variations of “Feeding and Eating Disorders” and “athletes” with “high school.” RESULTS A total of 20 pertinent articles were identified concerning DE in adolescent athletes. ED have been shown to impose higher rates of comorbidity than other psychological disorders and only a small number of individuals with ED seek treatment. ED tend to be more prevalent in adolescent elite athletes than non-athletes of both genders in all sports and levels of competition. CONCLUSIONS More rigorous tools for family practice physicians, nurses, and coaches to use when working with at-risk adolescent athletes are needed to identify DE behaviors. Healthcare and school professionals need to be educated and trained to detect DE and the components of the female athlete triad. Additional research with adolescent males or those associating with alternative gender roles is also required to help them prevent physical and mental health consequences associated with DE.","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44300861","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: 12

Disordered Eating and Eating Disorders in Adolescent Athletes. 青少年运动员的饮食紊乱和饮食失调。

Spartan medical research journal Pub Date : 2020-01-30

Ryley Mancine, Samantha Kennedy, Peter Stephan, Alyse Ley

{"title":"Disordered Eating and Eating Disorders in Adolescent Athletes.","authors":"Ryley Mancine, Samantha Kennedy, Peter Stephan, Alyse Ley","doi":"","DOIUrl":"","url":null,"abstract":"Context: To summarize available literature to date and discuss the importance of Disordered Eating (DE) in adolescent athletes, with special attention to the female athlete triad. In this paper, the authors will review the literature regarding adolescent athletes who intentionally engage in abnormal eating behaviors and focus on adolescent athletes of all training levels who may be affected by both DE and eating disorders (ED).Methods: In 2019, the authors completed a systematic literature search on PubMed using the search term variations of \"Feeding and Eating Disorders\" and \"athletes\" with \"high school.\"Results: A total of 20 pertinent articles were identified concerning DE in adolescent athletes. ED have been shown to impose higher rates of comorbidity than other psychological disorders and only a small number of individuals with ED seek treatment. ED tend to be more prevalent in adolescent elite athletes than non-athletes of both genders in all sports and levels of competition.Conclusions: More rigorous tools for family practice physicians, nurses, and coaches to use when working with at-risk adolescent athletes are needed to identify DE behaviors. Healthcare and school professionals need to be educated and trained to detect DE and the components of the female athlete triad. Additional research with adolescent males or those associating with alternative gender roles is also required to help them prevent physical and mental health consequences associated with DE.","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"4 2","pages":"11595"},"PeriodicalIF":0.0,"publicationDate":"2020-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25425071","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