Baylor University Medical Center Proceedings最新文献

{"title":"Incidence and treatment of game-related hip pointers between high school and collegiate football athletes.","authors":"Andrew T Sagendorf, Michael C Meyers, James C Sterling, Jarrett L Mitton, Shad K Robinson","doi":"10.1080/08998280.2026.2748812","DOIUrl":"https://doi.org/10.1080/08998280.2026.2748812","url":null,"abstract":"<p><strong>Background: </strong>Hip pointers are typically perceived as minor trauma with little cause for concern. Despite the possibility of long-term sequelae, limited research has been conducted on this topic.</p><p><strong>Methods: </strong>In this prospective cohort study, 89 high schools (4A to 6A) and 41 universities across all Football Bowl Subdivision (FBS) conferences were evaluated for game-related hip pointers over 12 (2010-2021) and 16 (2006-2021) seasons, respectively. Recruitment criteria were based on institutional size, level of sport skill, and the presence of a full-time athletic training staff. Outcomes of interest included total injuries, injury severity, injury category, primary type of trauma, injury situation, imaging and surgical procedures, player position, environmental factors, and playing surface. Injury incidence rates (IIRs) were calculated as injuries per 10 games = (number of injuries ÷ number of games) × 10.</p><p><strong>Results: </strong>Of 6031 games, 170 hip pointers were documented, with 63 (37.1%) reported during high school and 107 (62.9%) during collegiate play. Multivariate analyses of variance indicated a significant competitive level effect by total injuries (<i>F</i>_4,165 = 3.459; <i>P</i> = 0.01), primary type of trauma (<i>F</i>_10,159 = 2.967; <i>P</i> = 0.003), and injury situation (<i>F</i>_9,160 = 1.993; <i>P</i> = 0.04). Post hoc analyses indicated a significantly lower (<i>P</i> < 0.05) incidence of hip pointers (0.2, 95% CI 0.1-0.2 vs 0.5, 0.4-0.6) primarily during rushing plays (0.1, 95% CI, 0.1-0.1 vs 0.2, 0.1-0.2) among high school vs college athletes, respectively.</p><p><strong>Conclusion: </strong>A significantly greater incidence of hip pointers occurred during collegiate play when compared to high school competition. Addressing better ways to protect the hip, however, is recommended at both competitive levels.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149261742","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":"Three-dimensional patient-specific implants for cranioplasty: a systematic review of clinical outcomes, complications, workflow, and cost.","authors":"Arpit Sikri, Jyotsana Sikri, Karam Gaurvi Kashyap, Rinshul Saroch, Rasika Avinash Kulkarni, Rimple Gupta","doi":"10.1080/08998280.2026.2740991","DOIUrl":"https://doi.org/10.1080/08998280.2026.2740991","url":null,"abstract":"<p><strong>Background: </strong>Three-dimensional (3D) imaging, computer-aided design, and additive manufacturing have enabled patient-specific implants for individualized cranial reconstruction. However, evidence remains heterogeneous regarding materials, indications, study designs, and comparators. This study aimed to systematically evaluate clinical outcomes, complications, anatomical and cosmetic results, operative characteristics, and economic considerations associated with 3D-manufactured patient-specific cranioplasty implants.</p><p><strong>Methods: </strong>This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in PROSPERO (CRD42023486538). MEDLINE (PubMed), Scopus, and Web of Science were searched from inception to May 31, 2026. Eligible studies evaluated 3D-prototyped or 3D-manufactured patient-specific implants for cranial defect reconstruction. Two reviewers independently performed study selection and data extraction. Risk of bias was assessed using Joanna Briggs Institute critical appraisal tools. Due to substantial heterogeneity, findings were synthesized narratively.</p><p><strong>Results: </strong>Of 128 records identified, 48 articles underwent full-text assessment and 36 studies were included. Evidence comprised retrospective comparative studies, case series, technical reports, and clinical reports involving titanium, polyetheretherketone, polymethylmethacrylate, calcium-phosphate-based materials, and other constructs. Patient-specific implants generally demonstrated favorable anatomical conformity and cosmetic outcomes, with some studies reporting reduced intraoperative modification and operative time. However, complication outcomes were inconsistent and influenced by patient, surgical, material, and follow-up characteristics. Economic findings were heterogeneous.</p><p><strong>Conclusion: </strong>3D patient-specific implants are a feasible option for complex cranial reconstruction and precise contour restoration. However, current evidence does not establish universal superiority over autologous bone or other alloplastic materials. Larger prospective comparative studies with standardized clinical and economic outcomes are warranted.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149261683","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":"Improving access to dermatologic care: insights from a student-run free clinic.","authors":"Jun H Park, Megan Bradley, Andrew Spires, Alyssa Hansen, Juan Pinto-Cuberos, Anthony Linfante","doi":"10.1080/08998280.2026.2747597","DOIUrl":"https://doi.org/10.1080/08998280.2026.2747597","url":null,"abstract":"<p><p>Access to dermatologic care remains limited among uninsured and economically disadvantaged populations, contributing to delayed diagnosis and treatment. St. Vincent's Hope Clinic, a student-run free clinic in Galveston, Texas, offers monthly dermatology nights through a multidisciplinary model involving dermatology faculty, residents, and students from multiple health professions. From December 2024 to May 2025, 132 patient encounters demonstrated a broad range of dermatologic conditions, most commonly benign lesions (27.3%), psoriasis (11.8%), eczematous rashes (10.7%), and actinic keratoses (7.5%). Procedures included cryotherapy (41.1%), tangential biopsies (23.1%), and excisions (10.5%). This model provides no-cost specialty dermatologic evaluation and treatment to an underserved population while offering valuable interdisciplinary training. Expanding clinic capacity and implementing structured triage may improve access, prioritize urgent conditions, and reduce treatment delays.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149261711","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":"Adjuvant topical fluorouracil therapy for persistent superficial basal cell carcinoma post-Mohs micrographic surgery: long-term follow-up.","authors":"Adam Q He, Oliver Ha, Donn LaTour, Christopher Haley, Chad D Housewright","doi":"10.1080/08998280.2026.2747610","DOIUrl":"https://doi.org/10.1080/08998280.2026.2747610","url":null,"abstract":"<p><strong>Background: </strong>In cases where invasive basal cell carcinoma (BCC) subtypes (e.g., infiltrative and nodular) are treated with Mohs micrographic surgery (MMS), some patients may have residual superficial BCC (sBCC) following several stages of MMS after the invasive component has been cleared. Topical 5-fluorouracil (5-FU) is a well-studied chemotherapeutic agent, but long-term postoperative adjuvant outcome data are limited.</p><p><strong>Methods: </strong>We conducted a retrospective chart review from January 1, 2014, to April 14, 2025, including patients with residual sBCC who elected to forgo further Mohs stages and switch to 6 to 8 weeks of 5-FU following the final Mohs stage. A total of 139 patients were included, with a mean age of 78.5 years. Out of 166 BCC cases, 154 initial tumors had an invasive component (infiltrative and nodular subtypes).</p><p><strong>Results: </strong>We report a recurrence rate of 3.61% (6 of 166 cases) over a median follow-up period of 41.9 months.</p><p><strong>Conclusion: </strong>Our study demonstrates the potential effectiveness of topical 5-FU as an alternative adjuvant therapy for clearance of residual sBCC in patients with surgical fatigue.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149242713","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":"Myron McCall Nichols: a Connecticut Yankee in a Southern court.","authors":"Michael H Malloy","doi":"10.1080/08998280.2026.2747592","DOIUrl":"https://doi.org/10.1080/08998280.2026.2747592","url":null,"abstract":"<p><p>Myron McCall Nichols (1921-2013) was born in Bridgeport, Connecticut, was raised and educated in the Northeast, and by sheer chance of a military experience found his way to one of the premier pediatric programs developing in the country at the University of Texas Medical Branch (UTMB) under the leadership of Charles W. Daeschner (1920-2009). Dr. Nichols, affectionately known as Dr. Nick, was a scholar, musician, athlete, and showman always on stage to make a point to students, residents, and faculty colleagues or to generate a laugh from his poetry and musical antics. A self-taught neonatologist before there was such a board-certified designation, he developed what there was of an intensive care nursery at UTMB and offered observations through his scholarship on the burgeoning literature of the care of the neonate. This essay details how a Connecticut Yankee found himself deposited in the presence of a very Southern group of colleagues and his sure-footed adaptation to his surroundings.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236701","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":"Colchicine for refractory palisading and neutrophilic granulomatous dermatitis associated with mixed connective tissue disease.","authors":"Madelyn Schmidt, Julien Bourgeois, Anthony Linfante","doi":"10.1080/08998280.2026.2740966","DOIUrl":"https://doi.org/10.1080/08998280.2026.2740966","url":null,"abstract":"<p><p>We report a 38-year-old woman with mixed connective tissue disease (MCTD), interstitial lung disease, and inflammatory polyarthritis who developed progressively painful, firm papules on her bilateral elbows and dorsal hands. Histopathology confirmed palisaded neutrophilic granulomatous dermatitis (PNGD). Despite treatment with topical and intralesional corticosteroids, azathioprine, hydroxychloroquine, and belimumab over more than 2 years, her cutaneous lesions persisted, causing significant functional impairment. Colchicine was initiated at 0.6 mg daily and titrated to twice daily as tolerated. Following colchicine therapy, she experienced marked clinical improvement, with resolution of pain and near-complete clearance of papules. This case highlights colchicine as a potential therapeutic option for chronic, treatment-refractory PNGD associated with MCTD.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219706","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":"Patient and clinical characteristics associated with general anesthesia for cesarean delivery at a Texas level IV maternal care center: a single-center retrospective study.","authors":"Rachel Hoffman, Robert S White, Diana Villazana-Kretzer, Michael P Hofkamp","doi":"10.1080/08998280.2026.2748191","DOIUrl":"https://doi.org/10.1080/08998280.2026.2748191","url":null,"abstract":"<p><strong>Background: </strong>The primary aim of our study was to determine which patient and clinical characteristics were associated with general anesthesia (GA) for cesarean delivery (CD), and the secondary aim was to compare neonatal cord blood gas pH between patients who did and did not have GA for CD.</p><p><strong>Methods: </strong>We used a retrospective observational study design. Patients who had CD at Baylor Scott & White Medical Center - Temple from July 1, 2022, to June 30, 2024, were included in the study. We defined GA as placement of an endotracheal tube or supraglottic airway.</p><p><strong>Results: </strong>Of 1729 patients who had CD during the study period, 212 (12.3%) received GA. A 1-week increase in gestational age (adjusted odds ratio [aOR] 0.92; 95% confidence interval [CI] 0.88 to 0.96; <i>P</i> < 0.001) and emergency indication for CD (aOR 7.97; 95% CI 5.75 to 11.05; <i>P</i> < 0.001) were independently associated with receiving GA. The fetal cord blood gas pH values for patients who did and did not have GA for CD were similar.</p><p><strong>Conclusion: </strong>Emergency indications for CD increased GA, increasing gestational age decreased GA, and there was no difference in fetal cord blood gas pH between patients who did and did not have GA for CD.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219857","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":"Epidural to OR? Don't wait for the incision: recognizing the underperforming epidural.","authors":"Hannah White Burcham","doi":"10.1080/08998280.2026.2747595","DOIUrl":"https://doi.org/10.1080/08998280.2026.2747595","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219859","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":"Real-world screening for metabolic dysfunction-associated steatotic liver disease among adults with type 2 diabetes.","authors":"Michael L Volk, Anna Simons, Michelle Vanecek, Michael McNeal","doi":"10.1080/08998280.2026.2749324","DOIUrl":"https://doi.org/10.1080/08998280.2026.2749324","url":null,"abstract":"<p><strong>Background: </strong>New treatments for metabolic dysfunction-associated steatotic liver disease (MASLD) require identification of patients at risk of progressing to cirrhosis, yet population-based screening methods are not well established.</p><p><strong>Methods: </strong>We conducted a pilot screening study at a large academic primary care practice among patients with type 2 diabetes mellitus (T2DM). We calculated FIB-4 scores on existing labs and contacted providers with recommendations for additional testing with vibration-controlled transient elastography (VCTE) and/or specialty referral.</p><p><strong>Results: </strong>Among 2773 patients with T2DM seen at our clinic during the study period meeting inclusion criteria, 2396 had sufficient data to calculate FIB-4. After excluding lab results from the emergency department or inpatient setting, this left a final sample of 1315 patients. Among the 1315 patients included in the study, 78 (5.9%) had FIB-4 scores >2.66, while 732 (55.7%) had FIB-4 scores between 1.3 and 2.66. The <i>diagnostic yield</i> (proportion of patients receiving definitive diagnosis of MASLD with F2 or higher fibrosis as a result of the intervention) among the cohort with FIB-4 > 2.66 was 12/78 (15.4%). The most common reason for fall-out was the patient not wishing to receive further evaluation, with the second being provider concerns about competing risks.</p><p><strong>Discussion: </strong>The impact of population-level MASLD screening is limited by implementation barriers. Future efforts should focus on direct-to-patient outreach and methods to identify patients without competing risks who are most likely to benefit from MASLD diagnosis and specific treatment.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219820","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":"Diagnostic uncertainty in a patient with severe hidradenitis suppurativa revealing Buschke-Löwenstein tumor.","authors":"Garrett Sakamoto, Elma Zola, Ariann Howard, Salvatore Grasso, David Duarte","doi":"10.1080/08998280.2026.2731854","DOIUrl":"https://doi.org/10.1080/08998280.2026.2731854","url":null,"abstract":"<p><p>Buschke-Löwenstein tumor (BLT), also known as giant condyloma acuminatum, is a rare human papillomavirus-associated lesion characterized by locally aggressive growth with the potential for malignant transformation. Diagnosis may be particularly challenging when BLT arises in the setting of severe chronic inflammatory disease. We present a 44-year-old man with severe hidradenitis suppurativa, well-controlled HIV infection, recurrent gluteal abscesses, and chronic sacral osteomyelitis who presented with worsening perineal pain and chronic drainage. Although imaging demonstrated extensive infiltrative soft-tissue disease suspicious for neoplasm with superimposed infection, the patient's severe chronic inflammatory disease, recurrent abscesses, and chronic osteomyelitis created substantial diagnostic uncertainty. After the patient did not improve with broad-spectrum antimicrobial therapy, open biopsy of a large fungating perianal lesion established the diagnosis of BLT. This case highlights the diagnostic uncertainty that may arise when BLT coexists with severe hidradenitis suppurativa, emphasizing the importance of early tissue biopsy when clinical features are atypical or progressive.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191135","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}