Delaware medical journal最新文献

{"title":"The Effect of Surgical Approach on Strength and Function after Total Hip Arthroplasty.","authors":"Joseph Zeni,&nbsp;Kathleen Madara,&nbsp;James Rubano","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Although total hip arthroplasty (THA) has become standard procedure to manag the symptoms of end-stage osteoarthritis (OA), there are multiple surgical approaches to acceE the hip joint. To date, there is limited information on the effect of surgical approach on muscle strength and performance-based measures of functional ability after THA.</p><p><strong>Questions/purposes: </strong>The purpose of this study was to compare the effect of posterior or anterolateral surgical approaches on strength and function after THA. We hypothesized that individuals who underwent a posterior approach would have greater strength and performance-based measures of function than individuals who underwent an anterolateral approach one year after surgery. We also hypothesized that there would be no difference in pain or self-reported outcomes at follow-up.</p><p><strong>Methods: </strong>63 subjects were tested two to four weeks prior to THA and then three months and 12 months after THA. Subjects were divided into a posterior approach and lateral approac groups. Patients completed functional testing, strength measures, as well as self-reported questionnaires at each time point. Repeated-measures analysis of variance (ANOVA) tests were performed to test the change between the pre-operative and one year time point. Descriptive data were reported for all three time points.</p><p><strong>Results: </strong>There was a significant interaction effect for hip abduction strength (p=0.025) and the lateral group was significantly weaker at one year (p=0.018). No other variable demonstrated a significant interaction effect; however, all other variables with the exception of hip abductor strength (p=0.883) and pain on the non-operated side (p=0.527) demonstrated a significant main effect of time (p≤0.01) in which there was significant improvement at 1 year.</p><p><strong>Conclusion: </strong>The lateral surgical approaches result in weaker hip abduction one year after THA; however significant and clinically meaningful improvements in functional ability were seen for most subiects. regardless of surgical approach.</p>","PeriodicalId":75779,"journal":{"name":"Delaware medical journal","volume":"88 11","pages":"334-340"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36214659","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":"THE GOOD NUTRITION GAME: Extending the Good Behavior Game to Promote Fruit and Vegetable Intake.","authors":"Heather J Cassey,&nbsp;Yukiko Washio,&nbsp;Donald A Hantula","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Consumption of diverse and nutritious food is challenging for children diagnosed with Autism Spectrum Disorder.</p><p><strong>Objective: </strong>We created the Good Nutrition Game and implemented the intervention among students diagnosed with Autism Spectrum Disorder at a therapeutic after-school socialization program.</p><p><strong>Method: </strong>We divided students into two teams in each session. The team earned one point per bite of fruit or vegetables by a teammate. The winning team congratulated each other for winning and was given the privilege to choose a small prize item as reinforcement.</p><p><strong>Lessons learned: </strong>The approach showed promising findings to increase fruit and vegetable consumption among students diagnosed with Autism Spectrum Disorder in a classroom setting. While the approach needs to be implemented with more students in a longer term trial, other challenges include objectively measuring the number of bites instead of self-report by team members and addressing different eating habits among students.</p>","PeriodicalId":75779,"journal":{"name":"Delaware medical journal","volume":"88 11","pages":"342-345"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36214592","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":"Pediatric Head Injury in the Delaware Trauma System: Toward Improved Calibration of Severity and Resource Utilization.","authors":"Joseph Piatt,&nbsp;Diane Hochstuhl,&nbsp;Stephen Murphy","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>How the existence of trauma systems affects the care of less severely injured patients has received little attention.</p><p><strong>Objective: </strong>The current study examines the longitudinal effect on the care of children with traumatic brain injuries (TBIs) of the incorporation of a pediatric trauma center into a regional trauma system.</p><p><strong>Methods: </strong>The Delaware Trauma System provided registry data from 2000 to 2014. Inclusion criteria were age less than 18 years and ICD9 diagnostic coding for any head injury. Admissions were assessed as \"substantial\" or \"non-substantial\" based on study criteria. We hypothesized a step-wise increase in registrations of mild TBI and non-substantial admissions coinciding with the opening of Delaware's pediatric trauma center in late 2006.</p><p><strong>Results: </strong>There were 5,272 registrations. Before the opening of the pediatric trauma center, 1,737 of 2,038 (85.2 percent) head injuries were mild; afterwards mild TBI accounted for 2,894 of 3,230 registrations (89.6 percent; odds ratio 1.49, 95 percent Cl 1.26 - 1.76; p < 0.0001). Before the opening, 850 of 2,038 (41.7 percent) encounters were categorized as non-substantial; afterwards 1,528 of 3,230 admissions (47.3 percent) were non-substantial (odds ratio 1.25; 95 percent C 1.12 - 1.40; p < 0.0001). Inter-hospital transports within the system exhibited similar trends.</p><p><strong>Conclusions: </strong>Registrations of mild TBI and non-substantial admissions trended upward steadily during the years of this study with a suggestive step-wise increase correlating with the opening of a pediatric trauma center. Guidelines are needed to facilitate management of patients with minor injuries at the lowest appropriate level of care.</p>","PeriodicalId":75779,"journal":{"name":"Delaware medical journal","volume":"88 10","pages":"302-307"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36214630","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":"BEEBE HEALTHCARE: PHYSICIANS CARRY A DREAM FOR 100 YEARS.","authors":"Pam George","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75779,"journal":{"name":"Delaware medical journal","volume":"88 10","pages":"312-316"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36214631","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":"Restrictive Dermopathy: A Rare Disease with Unusual Radiographic Findings.","authors":"Omar Chohan,&nbsp;Reza J Daugherty,&nbsp;Louis Bartoshesky","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The patient is a unique case presenting with presumed Restrictive Dermopathy (RD) and intracranial and adrenal calcifications, an association not previously described in the literature. This case postulates the possibility of additional radiographic features that can be included in the spectrum of RD or as secondary events from the underlying pathophysiology of RD.</p>","PeriodicalId":75779,"journal":{"name":"Delaware medical journal","volume":"88 10","pages":"308-310"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36214635","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":"MSD: Making Strides to Make Your Life Easier.","authors":"Dorothy M Moore","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75779,"journal":{"name":"Delaware medical journal","volume":"88 9","pages":"265-6"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35972886","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":"Stump Appendicitis.","authors":"Roland M Dimaya,&nbsp;Novneet Sahu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Stump appendicitis is a delayed complication of appendectomy. Patients present with symptoms similar to an initial presentation for appendicitis. Diagnosis is often delayed as history of appendectomy often precludes focused workup for an appendiceal source of infection. A 39-year-old female presented to our emergency department with worsening abdominal pain and fever. Se had a past surgical history of a laparoscopic appendectomy approximately 14 months prior to presentation. During her admission, she was diagnosed with ruptured stump appendicitis by computerized tomography (CT) imaging. A percutaneous drain was placed and the patient was discharged with antibiotics. Follow up evaluation revealed clinical improvement, with resolution of peri-appendiceal stump inflammation and subsequent percutaneous drain removal. Completion appendectomy is tentatively scheduled. This case highlights awareness of stump appendicitis as a differential diagnosis for patients with previous appendectomy who present with acute abdominal pain.</p>","PeriodicalId":75779,"journal":{"name":"Delaware medical journal","volume":"88 9","pages":"276-8"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35971924","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":"Crystal Induced Acute Kidney Injury.","authors":"Efua Asamoah-Odei","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75779,"journal":{"name":"Delaware medical journal","volume":"88 8","pages":"244-246"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36042411","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":"Immunomodulatory Therapy and an Insidious Presentation of a Large Intra-Abdominal Abscess.","authors":"Emily Au,&nbsp;Ahmad Al-Taee,&nbsp;Muhammad B Hammami","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Crohn's disease is a disorder characterized by transmural inflammation which can potentially affect any part of the gastrointestinal tract from the mouth to the perianal area. Cohn's disease is a systemic disease characterized by a relapsing remitting course, with variable intestinal and extra-intestinal complications. Abdominal and pelvic abscesses are not an uncommon complication of Crohn's disease occurring in 10-30 percent of all patients. We present the case of a 21-year-old male with Crohn's disease presenting with a massive abdominal abscess, whose diagnosis was delayed given lack of typical symptoms. Shortly after initiating therapy with Prednisone and Adalimumab he presented with worsening abdominal distention. Cross sectional imaging of the abdomen with IV contrast (Figure 1) demonstrated a 34cm x 23 cm x 11 cm rim-enhancing fluid collections in the abdomen and pelvis consistent with a large intra-abdominal abscess. He underwent an exploratory laparotomy, abdominal washout, and wound vacuum placement. Five liters of purulent fluid were aspirated and cultures grew citrobacter, veillonella and candida glabrata.\u0000A bowel perforation was suspected as the etiology for abscess formation; however magnetic resonance heterography (Figure2) was unremarkable. He was treated with appropriate antibiotics, antifungal agents, and was started on Aprisa. His course was complicated with recurrence of intra-abdominal abscesses and a colocutaneous fistula for which he underwent an open sigmoidectomy with a diverting loop colostomy. After condirmation of healing with repeat imaging, he was an uneventful postoperative course. He followed as an outpatient and continues to do well on Infliximab.\u0000Most abscesses are picked up in their early stages given characteristic symptoms; however in presence of immunosuppressive therapy the host immune system can be suppressed leading to delayed diagnosis. The presence of a massive intra-abdominal purulent fluid collection of this size has not been described on our review of the literature. Furthermore, despite the abscess taking up most of the abdominal cavity, the fairly limited symptom burden highlights the importance of having high degree of clinical suspicion for infectious compications in Crohn's disease patients even when classical symptoms are not present.</p>","PeriodicalId":75779,"journal":{"name":"Delaware medical journal","volume":"88 9","pages":"280-2"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35971931","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":"STEMI in Pregnancy.","authors":"Erum Siddiqui,&nbsp;Jon McGhee","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75779,"journal":{"name":"Delaware medical journal","volume":"88 8","pages":"242-243"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36042407","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}