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A Resident-Led Quality Improvement Project in a Community Based Hospital Emergency Department - The Benefits of Simplified Plan-Do-Study-Act/Patient-Safety Quality Improvement Projects Regardless of Staffing Levels. 社区医院急诊科居民主导的质量改进项目--无论人员配备水平如何,简化的 "计划-实施-研究-行动/患者安全 "质量改进项目的益处。
Spartan medical research journal Pub Date : 2024-09-09 eCollection Date: 2024-01-01 DOI: 10.51894/001c.123236
Martina Ghiardi, Shauncie Skidmore, Christina George, Rachael Crise, Olga J Santiago
{"title":"A Resident-Led Quality Improvement Project in a Community Based Hospital Emergency Department - The Benefits of Simplified Plan-Do-Study-Act/Patient-Safety Quality Improvement Projects Regardless of Staffing Levels.","authors":"Martina Ghiardi, Shauncie Skidmore, Christina George, Rachael Crise, Olga J Santiago","doi":"10.51894/001c.123236","DOIUrl":"https://doi.org/10.51894/001c.123236","url":null,"abstract":"<p><strong>Introduction: </strong>An emergency department (ED) resident believed ED patients, who needed a simple laceration repair, would be better served if the ED used a laceration cart for supplies, as opposed to the hunt-and-gather method for collecting needed supplies. To address this issue, a two-step Plan-Do-Study-Act/Patient-Safety quality improvement (PDSA/PS QI) project was initiated, with the intent that the project could be completed in a timely manner regardless of staffing levels. The primary purpose of the project was two-fold: 1) to explore the possible time-to-repair benefits of using a laceration repair supply cart in the emergency department and 2) to determine the feasibility of conducting a simple multi-cycle PDSA/PS QI project in a potential staffing-shortage environment.</p><p><strong>Methods: </strong>A prospective study using a simple 2-cycle PDSA/PS QI procedure was initiated. During cycle 1, baseline data, to determine the time to complete simple-laceration repairs using a hunt-and-gather supply process, was collected in the form of sign-out/return sheets located next to a laceration repair kit. Cycle 2 introduced the use of a simple-laceration supply cart in the ED, with data collected in the form of a sign-out/return sheet located on the supply cart. Data analysis included a two-sample Wilcoxon rank-sum (Mann-Whitney) test to assess the effectiveness of the suture cart implementation.</p><p><strong>Results: </strong>Pre-intervention. Twelve valid cases were recorded on the sign-out/return sheets. The baseline time range to complete a simple laceration repair varied from 26 minutes to 151 minutes, with an average of 68.3 minutes (SD=40.8).Post-intervention. Twenty-nine valid cases were recorded on the revised sign-out/return sheet. The time to complete a simple laceration repair, using the supply cart, varied from 10 minutes to 116 minutes, with a mean of 36.9 minutes (SD=25.0), a statistically significant average decrease (p = 0.005) of 31.4 minutes.</p><p><strong>Conclusion: </strong>The use of a suture repair cart in the ED reduced the time required for physicians to perform a simple laceration repair. A minimal 2-cycle PDSA/PS QI process allowed residents and staff to participate in a quality-improvement project, even in a potential staffing-shortage environment.</p>","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"9 3","pages":"123236"},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11389386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302971","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
CASE REPORT: GUILLAIN-BARRE SYNDROME, AN UNUSUAL PRESENTATION. 病例报告:格林巴利综合征,一种不寻常的表现。
Spartan medical research journal Pub Date : 2024-08-30 eCollection Date: 2024-01-01 DOI: 10.51894/001c.123042
Ania Pathak
{"title":"CASE REPORT: GUILLAIN-BARRE SYNDROME, AN UNUSUAL PRESENTATION.","authors":"Ania Pathak","doi":"10.51894/001c.123042","DOIUrl":"https://doi.org/10.51894/001c.123042","url":null,"abstract":"","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"9 2","pages":"123042"},"PeriodicalIF":0.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121300","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
Abstracts From the First Annual Research Day Hosted by the Michigan State University College of Osteopathic Medicine, Novi, Michigan, May 15, 2023. 密歇根州立大学骨科医学院主办的第一届年度研究日摘要,密歇根州诺维,2023 年 5 月 15 日。
Spartan medical research journal Pub Date : 2024-03-27 eCollection Date: 2024-01-01 DOI: 10.51894/001c.115618
Andrea Amalfitano, Patricia Obando, Rana Ismail, Francis Akenami
{"title":"Abstracts From the First Annual Research Day Hosted by the Michigan State University College of Osteopathic Medicine, Novi, Michigan, May 15, 2023.","authors":"Andrea Amalfitano, Patricia Obando, Rana Ismail, Francis Akenami","doi":"10.51894/001c.115618","DOIUrl":"https://doi.org/10.51894/001c.115618","url":null,"abstract":"<p><p>The Spartan Medical Research Journal (SMRJ) is pleased to publish abstracts from the First Annual Research Day hosted by the Michigan State University College of Osteopathic Medicine (MSUCOM), held in Novi, Michigan, on May 15, 2023. Sponsored by MSUCOM, the Statewide Campus System (SCS), and Research, Innovation, and Scholarly Engagement (RISE), this event showcased a total of 139 selected research abstracts following a meticulous blinded review by the MSUCOM Research Day Planning Committee and SMRJ editorial staff. These abstracts were subsequently presented at the MSUCOM First Annual Research Day in 2023, with awards for exceptional oral and poster presentations conferred on May 15, 2023. Of the 139 presentations that were ultimately chosen, 45 authors consented and elected to have their abstracts published in SMRJ. The abstracts from 2023 encompass a wide array of contemporary medical and clinical subjects, incorporating a variety of research designs that cover basic science, clinical research, case reports, medical education, and quality improvement. While abstracts offer concise overview of research projects or presentations, they do not permit a comprehensive evaluation of the scientific rigor employed in the respective works. Although these abstracts offer preliminary results that may necessitate further refinement and validation, they serve a vital function in disseminating novel research concepts and advancements in the discipline of medicine. This knowledge-sharing promotes meaningful dialogue among researchers, clinicians, and educators, thereby making a valuable contribution to the collective body of knowledge in the fields of medical sciences and osteopathic medicine. <b>Andrea Amalfitano, DO, PhD</b> Osteopathic Heritage Foundation Professor of Pediatrics, Microbiology and Molecular Genetics Professor, BioMolecular Science Gateway Editor-in-Chief, Spartan Medical Research Journal (SMRJ) MSU College of Osteopathic Medicine- Statewide Campus System <b>C. Patricia Obando S., PhD</b> Associate Dean and DIO, Graduate Medical Education Associate Professor- MSU College of Osteopathic Medicine- Statewide Campus System <b>Rana Ismail, PhD, MSc, CPHQ</b> Director of Research Editor, Spartan Medical Research Journal (SMRJ) MSU College of Osteopathic Medicine- Statewide Campus System <b>Francis Akenami, BMLS, PhD, MSc, FIMLS</b> Managing Editor Spartan Medical Research Journal (SMRJ) MSU College of Osteopathic Medicine- Statewide Campus System.</p>","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"9 1","pages":"115618"},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11191887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443900","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
An Approach to Improving Compliance of Treatment in Asymptomatic Bacteriuria. 提高无症状细菌尿治疗依从性的方法。
Spartan medical research journal Pub Date : 2023-12-05 eCollection Date: 2023-01-01
Johnathan Lewis, Angelic Dye, Tracy Koehler, Justin Grill, Sarah Baribeau, Caleb Bryant
{"title":"An Approach to Improving Compliance of Treatment in Asymptomatic Bacteriuria.","authors":"Johnathan Lewis, Angelic Dye, Tracy Koehler, Justin Grill, Sarah Baribeau, Caleb Bryant","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Asymptomatic bacteriuria (ASB) is the presence of bacteria in the urine without attributable signs or symptoms of a urinary tract infection (UTI). This condition is often inappropriately treated per the 2019 Infectious Disease Society of America guidelines. This quality improvement project aimed to reduce improper treatment of ASB via a three-phase spaced repetition approach over a 12-month 2021-2022 period within a Michigan emergency department (ED), targeting 43 ED clinicians.</p><p><strong>Methods: </strong>During Phase I, a 20-minute teleconference educational intervention was delivered by an Infectious Disease physician and pharmacist. During Phase II, a \"hard stop\" was implemented within the electronic health record preventing reflex urinalysis culture without indication. During Phase III, a latent period of no intervention took place. The authors' goal was to achieve > 80% compliance to ASB treatment guidelines.</p><p><strong>Results: </strong>Overall compliance after the project initiative was 66.7%, an absolute increase of 16.7% from baseline compliance. Using data from 54 patients, this represented a statistically significant (p = 0.01) increase from baseline but fell short of the target of > 80%.</p><p><strong>Discussion: </strong>Although the authors fell short of their goal of a 30% increase, data from the project suggests a spaced repetition approach to education and workflow changes could be an effective method to increasing medical provider compliance with treatment of ASB.</p><p><strong>Conclusion: </strong>Identifying the ideal strategy to change treatment patterns of ED clinicians for ASB to align with guidelines remains key. There is still a need for ongoing efforts in this realm for progress to be made. Keywords: asymptomatic bacteriuria, urinary tract infection, compliance, spaced repetition, antibiotics.</p>","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"8 1","pages":"38898"},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10702150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814934","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
Patients with COVID-19 Pneumonia Admitted to an Intensive Care Unit (ICU) at a Community Hospital in Flint, Michigan, in Early 2020: Characteristics and Mortality. 2020 年初密歇根州弗林特市一家社区医院重症监护室 (ICU) 收治的 COVID-19 肺炎患者:特征和死亡率。
Spartan medical research journal Pub Date : 2023-12-05 eCollection Date: 2023-01-01
Atefeh Kalantary, Olga J Santiago-Rivera, Arunima Dutta, Chace Davies, Bilal Malik, Parul Sud, Ibrahim Al-Sanouri
{"title":"Patients with COVID-19 Pneumonia Admitted to an Intensive Care Unit (ICU) at a Community Hospital in Flint, Michigan, in Early 2020: Characteristics and Mortality.","authors":"Atefeh Kalantary, Olga J Santiago-Rivera, Arunima Dutta, Chace Davies, Bilal Malik, Parul Sud, Ibrahim Al-Sanouri","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the many studies conducted on the factors affecting mortality in patients with COVID-19, there is ongoing debate about the role of race as a risk factor. Several studies have reported a geographic and racial disparity in COVID-19 cases in Michigan. This study aimed to examine the characteristics of the 2020 first cohort of Intensive Care Unit (ICU) COVID-19 patients admitted to a community teaching hospital in Flint, Michigan, and to determine the factors associated with ICU mortality, including race.</p><p><strong>Methods: </strong>This cross-sectional study included adult patients (≥ 18 years) with severe COVID-19 pneumonia admitted to the ICU between March and May 2020. Potential risk factors associated with ICU mortality included demographic characteristics, comorbidities, treatments, and complications.</p><p><strong>Results: </strong>The study sample consisted of N = 48 patients, aged 24-85 years, (mean 59.7; SD = 12.8); 56.2% (n=27) were male and 51.1% (n=24) were Black adults. The mortality rate was 51.1%. Age (aOR 1.1, 95% CI [1.01, 1.20]; p =0.03), type 2 diabetes (aOR 5.7, 95% CI [1.2, 29.1]; p =0.03), and essential hypertension (aOR 6.2, 95% CI [1.1, 34.5]; p =0.04) were all found to have statistically significant independent associations with increased risk of ICU mortality in this study sample. On the other hand, race was not found to be associated with ICU mortality.</p><p><strong>Conclusions: </strong>These findings support the literature regarding the association of comorbid conditions, including type 2 diabetes and hypertension, with poorer outcomes in ICU hospitalized patients with severe COVID-19 pneumonia. This study provides insight into mortality of an ICU patient cohort earlier on during the COVID-19 pandemic in Flint, Michigan.</p>","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"8 1","pages":"89371"},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10702153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138815039","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
Neuroforaminal Stenosis in the Lumbosacral Spine: A Scoping Review of Pathophysiology, Clinical Manifestations, Diagnostic Imaging, and Treatment. 腰骶椎神经孔狭窄症:病理生理学、临床表现、影像诊断和治疗的范围综述》。
Spartan medical research journal Pub Date : 2023-12-05 eCollection Date: 2023-01-01
Daniel R Cavazos, Devan O Higginbotham, Fong Nham, Tannor Court, Scott McCarty, Anil Sethi, Rahul Vaidya
{"title":"Neuroforaminal Stenosis in the Lumbosacral Spine: A Scoping Review of Pathophysiology, Clinical Manifestations, Diagnostic Imaging, and Treatment.","authors":"Daniel R Cavazos, Devan O Higginbotham, Fong Nham, Tannor Court, Scott McCarty, Anil Sethi, Rahul Vaidya","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To conduct the first scoping review of lumbosacral neuroforaminal stenosis with respect to the pathophysiology, symptomatic manifestations, diagnostic imaging, and treatment options.</p><p><strong>Methods: </strong>A scoping literature review was conducted in accordance with the recommendations set forth by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), with English language restrictions stipulated to include articles pertaining to lumbosacral neuroforaminal stenosis. Databases maintained by PubMed, National Library of Medicine, Cochrane Central Register of Controlled Trials (Ovid), Scopus (Elsevier), Web of Science (Thomson Reuters), and Google Scholar were queried from their inception date through December 2022.</p><p><strong>Summary of the evidence: </strong>A total of 276 articles were reviewed and 29 articles were included within the study. Within these articles, the anatomic origins of neuroforaminal stenosis were reviewed in detail and the resulting clinical manifestations were discussed. Recent studies evaluating the efficacy of existing diagnostic imaging modalities were summarized, along with potential future methods to improve sensitivity for detecting this entity and measuring foraminal stenosis via novel imaging techniques. Based on the literature, the conservative management and surgical treatment of lumbosacral foraminal stenosis were discussed.</p><p><strong>Conclusions: </strong>Lumbar neuroforaminal stenosis represents a significant source of radicular pain that is often compounded by delayed diagnosis and incomplete treatment. This article represents the first scoping review of lumbosacral neuroforaminal stenosis with focus on diagnosis, management, and treatment for associated radicular pain. The goal is to reduce the incidence of untreated or unrecognized neuroforaminal stenosis in the setting of a complex decompression and fusion, as well as to promote minimally invasive surgery to address radicular pain from neuroforaminal stenosis. Recent advances in diagnostic imaging and surgical techniques have the potential to improve the timeliness and durability of patients' treatment options. Future directions for the diagnostic imaging of foraminal stenosis include efforts aimed at developing the nascent field of computerized mapping to reliably quantify stenosis and its impact on the exiting nerve root and associated dorsal root ganglia.</p>","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"8 1","pages":"87848"},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10702154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814938","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
Secondary Postoperative Hemorrhage in the Pediatric Tonsillectomy Patient- is there a correlation between hemorrhage and tonsilloliths? 小儿扁桃体切除术患者术后继发性出血--出血与扁桃体结石之间有关联吗?
Spartan medical research journal Pub Date : 2023-12-05 eCollection Date: 2023-01-01
Andrew Ross, Ani Mnatsakanian, Jacob Markovicz, Sruti Desai, Brian Anderson, Holly Shifman, Steven Engebretsen, Carissa Wentland, Prasad Thottam, Michael Haupert
{"title":"Secondary Postoperative Hemorrhage in the Pediatric Tonsillectomy Patient- is there a correlation between hemorrhage and tonsilloliths?","authors":"Andrew Ross, Ani Mnatsakanian, Jacob Markovicz, Sruti Desai, Brian Anderson, Holly Shifman, Steven Engebretsen, Carissa Wentland, Prasad Thottam, Michael Haupert","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Tonsillectomy with or without adenoidectomy is one of the most common ambulatory procedures performed in children under 15. One rare yet serious complication of tonsillectomy is postoperative hemorrhage. Chronic tonsillitis, which is an indication for tonsillectomy, has been shown to have an increased risk for postoperative hemorrhage. Tonsilloliths or tonsil stones have been associated with cryptic tonsillitis. This 2020-2021 study examined whether tonsilloliths were a risk factor for post-tonsillectomy hemorrhage in a convenience sample of 187 pediatric patients.</p><p><strong>Methods: </strong>This was a cross-institutional 12-month retrospective cohort study investigating pediatric patients who had undergone tonsillectomy. Exclusion criteria included patients who had received prior airway surgeries (e.g., supraglottoplasty), patients with significant comorbidities such as chromosomal abnormalities or congenital disorders, and patients with pre-existing bleeding disorders. Demographic, clinical, and operative data was extracted from each chart. Postoperative adverse events and bleeding were also recorded. These factors were then compared between the tonsillolith and no tonsillolith patient groups.</p><p><strong>Results: </strong>A total of 187 pediatric patients met the inclusion criteria. Seventy-three (39%) of the patients had tonsilloliths and 114 (61%) did not have tonsilloliths at the time of surgery. The tonsillolith subgroup had a higher median age (10 vs 3, P < 0.001) when compared to the no tonsillolith subgroup. The most common indication for tonsillectomy was obstructive sleep apnea/sleep disordered breathing (N= 148, 79.1%). There was no statistical difference found between presence of tonsillolith and indication for surgery (P = 0.06). Only five (2.7%) of sample patients experienced postoperative bleeding and there was no association found between postoperative bleeding and presence of tonsilloliths (P = 0.38).</p><p><strong>Conclusion: </strong>In the current study there was no association found between the presence of tonsilloliths (indicating low grade chronic inflammation) and hemorrhage after tonsillectomy. Continued larger sample evaluations of possible risk factors for post-tonsillectomy hemorrhage patterns are encouraged.</p>","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"8 1","pages":"57320"},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10702155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138815000","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
Midline Sacral Fractures: Review of the Literature. 骶骨中线骨折:文献综述。
Spartan medical research journal Pub Date : 2023-12-05 eCollection Date: 2023-01-01
Ivan Bandovic, Benjamin Diedring, Adrian Olson, Sean Tan, Marek Denisuk, Dexter Powell, Benjamin Best
{"title":"Midline Sacral Fractures: Review of the Literature.","authors":"Ivan Bandovic, Benjamin Diedring, Adrian Olson, Sean Tan, Marek Denisuk, Dexter Powell, Benjamin Best","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Sacral fractures are an important consideration in high-energy traumas associated with injuries to the pelvic ring that confer much of pelvic stability. A midline longitudinal sacral fracture (MLS) is a relatively rare fracture pattern, with only 23 cases of MLS fractures reported in the literature to date. This systematic review evaluates overall mechanisms of MLS injury, associated injuries, complications, management, and fracture prognosis.</p><p><strong>Methods: </strong>A 1952-2021 PubMed literature search yielded 11 publications reporting the outcomes of a total of 23 MLS fracture cases.</p><p><strong>Results: </strong>Of the 23 MLS patients, 15 (65%) were male and eight (35%) were female, with an average age of 37.25. Ten (43.5%) MLS fractures occurred during motor vehicle collisions and eight (34.7%) because of motorcycle accidents. The most common pelvic ring injuries associated with MLS were pubic symphysis diastasis (n = 12, 57%) and pubic ramus fractures (n = 11, 48%). Patients most frequently suffered intra-pelvic organ dysfunction such as sexual dysfunction or bowel/bladder/urethral injuries. Fractures were treated both operatively or non-operatively and generally showed clinical meaningful resolution at 10 weeks post-injury.</p><p><strong>Conclusions: </strong>MLS injuries most often occur in high-energy trauma due to motor vehicle or motorcycle accidents as well as crush injuries, leg splitting, direct perineal/perianal impacts. Pre-trauma sacral abnormalities could be potentially predisposing factors correlated with MLS fractures. Careful review of x-rays and CT scans may help reveal MLS fractures, which can go initially undiagnosed. Operative and nonoperative management strategies includes bedrest, transsacral transiliac screw, decompressive laminotomies, and/or pelvic external fixation. The outcomes reported to date have been generally favorable, with most patients healing at approximately 10 weeks. Keywords: Midline sacral fracture; vertical sacral fracture; sacrum; pelvic ring injury.</p>","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"8 1","pages":"38909"},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10702151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814936","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
Using Artificial Intelligence to Semi-Quantitate Coronary Calcium as an 'Incidentaloma' on Non-Gated, Non-Contrast CT Scans, A Single-Center Descriptive Study in West Michigan. 西密歇根州的一项单中心描述性研究:使用人工智能对非门控、非对比 CT 扫描中作为 "偶然瘤 "的冠状动脉钙进行半量化。
Spartan medical research journal Pub Date : 2023-12-05 eCollection Date: 2023-01-01
Connor C Kerndt, Rajus Chopra, Paul Weber, Amy Rechenberg, Daniel Summers, Thomas Boyden, David Langholz
{"title":"Using Artificial Intelligence to Semi-Quantitate Coronary Calcium as an 'Incidentaloma' on Non-Gated, Non-Contrast CT Scans, A Single-Center Descriptive Study in West Michigan.","authors":"Connor C Kerndt, Rajus Chopra, Paul Weber, Amy Rechenberg, Daniel Summers, Thomas Boyden, David Langholz","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Non-gated, non-contrast computed tomography (CT) scans are commonly ordered for a variety of non-cardiac indications, but do not routinely comment on the presence of coronary artery calcium (CAC)/atherosclerotic cardiovascular disease (ASCVD) which is known to correlate with increased cardiovascular risk. Artificial intelligence (AI) algorithms can help detect and quantify CAC/ASCVD which can lead to early treatment and improved outcomes.</p><p><strong>Methods: </strong>Using an FDA-approved algorithm (NANOX AI) to measure coronary artery calcium (CAC) on non-gated, non-contrast CT chest, 536 serial scans were evaluated in this single-center retrospective study. Scans were categorized by Agatston scores as normal-mild (<100), moderate (100-399), or severe (≥400). AI results were validated by cardiologist's overread. Patient charts were retrospectively analyzed for clinical characteristics.</p><p><strong>Results: </strong>Of the 527 patients included in this analysis, a total of 258 (48.96%) had moderate-severe disease; of these, 164 patients (63.57%, p< 0.001) had no previous diagnosis of CAD. Of those with moderate-severe disease 135 of 258 (52.33% p=0.006) were not on aspirin and 96 (37.21% p=0.093) were not on statin therapy. Cardiologist interpretation demonstrated 88.76% agreement with AI classification.</p><p><strong>Discussion/conclusion: </strong>Machine learning utilized in CT scans obtained for non-cardiac indications can detect and semi-quantitate CAC accurately. Artificial intelligence algorithms can accurately be applied to non-gated, non-contrast CT scans to identify CAC/ASCVD allowing for early medical intervention and improved clinical outcomes.</p>","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"8 1","pages":"89132"},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10702149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138815107","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
Open Fractures in National Football League Athletes: Analyzing Performance and Return to Sport. 国家橄榄球联盟运动员的开放性骨折:分析表现和运动恢复情况。
Spartan medical research journal Pub Date : 2023-12-05 eCollection Date: 2023-01-01
Brandon Nudelman, Brandon B Gardner, Stewart A Bryant, Drew A Lansdown, Brian T Feeley, Nirav K Pandya
{"title":"Open Fractures in National Football League Athletes: Analyzing Performance and Return to Sport.","authors":"Brandon Nudelman, Brandon B Gardner, Stewart A Bryant, Drew A Lansdown, Brian T Feeley, Nirav K Pandya","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Open fractures are potentially devastating injuries for the professional athlete. We sought to compare return to sports (RTS) and performance in National Football League (NFL) athletes sustaining open versus closed fractures.</p><p><strong>Methods: </strong>NFL athletes with surgically treated open and closed fractures of the forearm, tibial shaft, and ankle from 2009-2018 were identified through publicly available reports and records. Data including demographics, RTS, career duration, and the approximate value performance metric before and after injury were collected. Statistical analyses were performed comparing open to closed injuries. Continuous variables were compared using Mann-Whitney U or two sample t- tests while categorical variables were compared using Fisher's exact test.</p><p><strong>Results: </strong>Ninety-five athletes met inclusion criteria (10 open and 85 closed fractures). Overall, 90% (n = 9) returned to sport after an open injury and 83.5% (n = 71) returned after closed injury with a median time missed of 48.9 (range 35.1 - 117.4) weeks and 43.0 (range 2.4 - 108.0) weeks, respectively. Athletes undergoing forearm surgery were able to return sooner, at around 20.8 weeks, and ankle fractures conferred the lowest return rate at 80% (n = 48). There were no significant differences in career duration and post-injury performance between open or closed fracture cohorts.</p><p><strong>Conclusions: </strong>Although open fractures are relatively uncommon injuries seen in NFL athletes, our study suggests RTS for these players is high. Athletes undergoing surgical treatment for open fractures had similar RTS rates, performance metrics, and career durations compared to those with comparable closed fractures. This information can provide guidance for providers counseling elite athletes on postoperative expectations.</p>","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"8 1","pages":"87846"},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10702152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814942","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}
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