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Therapeutic Application Of Carbon Monoxide In Acute Limb Compartment Syndrome, Aurelia Bihari 2017 The University of Western Ontario

Therapeutic Application Of Carbon Monoxide In Acute Limb Compartment Syndrome, Aurelia Bihari

Electronic Thesis and Dissertation Repository

Acute limb compartment syndrome (CS), a devastating complication of musculoskeletal trauma, develops in response to elevation of the pressure within a closed osseofascial compartment, producing muscle- and limb-threatening ischemia. Full decompression of all involved compartments by fasciotomy is the current gold-standard therapy, but it must be performed within a surgical window of 6-8 hours, before tissue damage becomes permanent.

Carbon monoxide (CO), a byproduct of heme metabolism, has been shown protective in ischemia. While inhalation of CO leads to elevation of carboxyhemoglobin (COHb), recent development of transitional metal carbonyls, CO-releasing molecules (CO-RMs), particularly the water-soluble CORM-3, delivers CO in a ...


Differential Burden Of Musculoskeletal Pain In African Americans And Whites Patients At The Time Of Total Joint Replacement Surgery, Leslie R. Harrold, Anthony Porter, Philip C. Noble, David C. Ayers, Jeroan J. Allison, Patricia D. Franklin 2017 University of Massachusetts Medical School

Differential Burden Of Musculoskeletal Pain In African Americans And Whites Patients At The Time Of Total Joint Replacement Surgery, Leslie R. Harrold, Anthony Porter, Philip C. Noble, David C. Ayers, Jeroan J. Allison, Patricia D. Franklin

Orthopedics and Physical Rehabilitation Publications and Presentations

Objective: African Americans patients have greater operative joint pain and functional limitation at the time of total joint replacement (TJR) compared to white patients. We examined the factors associated with this apparent disparity.

Methods: A consecutive sample of 5745 patients with advanced knee and hip osteoarthritis [who elected to undergo TJR in 2011-201] reported, preoperatively, medical comorbidities, operative and non-operative hip/ knee pain using Hip and Knee Disability and Osteoarthritis Outcome Scores (HOOS/KOOS), function using Short Form 36 Physical Component Score (PCS). Total burden of musculoskeletal pain was quantified as moderate/severe pain in non-operative hip and knee joints ...


Assessing Function And Endurance In Adults With Spinal And Bulbar Muscular Atrophy: Validity Of The Adult Myopathy Assessment Tool, Michael O. Harris-Love, Lindsey E. Rhodes, Galen Joe, Joseph A. Shrader, Sungyoung Auh, Cheunju Chen, Li Li, Ellen Levy, Todd E. Davenport, Nicholas DiProspero, Kenneth H. Fischbeck 2017 George Washington University

Assessing Function And Endurance In Adults With Spinal And Bulbar Muscular Atrophy: Validity Of The Adult Myopathy Assessment Tool, Michael O. Harris-Love, Lindsey E. Rhodes, Galen Joe, Joseph A. Shrader, Sungyoung Auh, Cheunju Chen, Li Li, Ellen Levy, Todd E. Davenport, Nicholas Diprospero, Kenneth H. Fischbeck

Todd Davenport

Purpose. The adult myopathy assessment tool (AMAT) is a performance-based battery comprised of functional and endurance subscales that can be completed in approximately 30 minutes without the use of specialized equipment. The purpose of this study was to determine the construct validity and internal consistency of the AMAT with a sample of adults with spinal and bulbar muscular atrophy (SBMA). Methods. AMAT validity was assessed in 56-male participants with genetically confirmed SBMA (mean age, 53 ± 10 years). The participants completed the AMAT and assessments for disease status, strength, and functional status. Results. Lower AMAT scores were associated with longer disease ...


Legal Aspects Of Aerobic Capacity: Objective Evidence Of The Ability To Work, Margaret E. Ciccolella, Tommy Boone, Todd E. Davenport 2017 University of the Pacific

Legal Aspects Of Aerobic Capacity: Objective Evidence Of The Ability To Work, Margaret E. Ciccolella, Tommy Boone, Todd E. Davenport

Todd Davenport

The article discusses the legality of aerobic capacity testing in disability cases particularly chronic fatigue syndrome (CFS). It says that aerobic capacity testing can be used to document functional impairments in patients with CFS after the failure of Functional Capacity Evaluation (FCE) in evaluating the ability to work of CFS patients who claim for insurance benefits. It presents case law reviews that illustrate the importance of expert testimony in disability related insurance benefit.


Patient-Reported Outcome Measures In Arthroplasty Registries Report Of The Patient-Reported Outcome Measures Working Group Of The International Society Of Arthroplasty Registries Part Ii. Recommendations For Selection, Administration, And Analysis, Ola Rolfson, Eric Bohm, Patricia D. Franklin, Stephen Lyman, Geke Denissen, Jill Dawson, Jennifer Dunn, Kate Eresian Chenok, Michael Dunbar, Soren Overgaard, Goran Garellick, Anne Lubbeke 2017 University of Gothenburg

Patient-Reported Outcome Measures In Arthroplasty Registries Report Of The Patient-Reported Outcome Measures Working Group Of The International Society Of Arthroplasty Registries Part Ii. Recommendations For Selection, Administration, And Analysis, Ola Rolfson, Eric Bohm, Patricia D. Franklin, Stephen Lyman, Geke Denissen, Jill Dawson, Jennifer Dunn, Kate Eresian Chenok, Michael Dunbar, Soren Overgaard, Goran Garellick, Anne Lubbeke

Patricia D. Franklin

The International Society of Arthroplasty Registries (ISAR) Patient-Reported Outcome Measures (PROMs) Working Group have evaluated and recommended best practices in the selection, administration, and interpretation of PROMs for hip and knee arthroplasty registries. The 2 generic PROMs in common use are the Short Form health surveys (SF-36 or SF-12) and EuroQol 5-dimension (EQ-5D). The Working Group recommends that registries should choose specific PROMs that have been appropriately developed with good measurement properties for arthroplasty patients. The Working Group recommend the use of a 1-item pain question ("During the past 4 weeks, how would you describe the pain you usually have ...


Patient-Reported Outcome Measures In Arthroplasty Registries, Ola Rolfson, Kate Eresian Chenok, Eric Bohm, Anne Lubbeke, Geke Denissen, Jennifer Dunn, Stephen Lyman, Patricia D. Franklin, Michael Dunbar, Soren Overgaard, Goran Garellick, Jill Dawson 2017 University of Gothenburg

Patient-Reported Outcome Measures In Arthroplasty Registries, Ola Rolfson, Kate Eresian Chenok, Eric Bohm, Anne Lubbeke, Geke Denissen, Jennifer Dunn, Stephen Lyman, Patricia D. Franklin, Michael Dunbar, Soren Overgaard, Goran Garellick, Jill Dawson

Patricia D. Franklin

The International Society of Arthroplasty Registries (ISAR) Steering Committee established the Patient-Reported Outcome Measures (PROMs) Working Group to convene, evaluate, and advise on best practices in the selection, administration, and interpretation of PROMs and to support the adoption and use of PROMs for hip and knee arthroplasty in registries worldwide. The 2 main types of PROMs include generic (general health) PROMs, which provide a measure of general health for any health state, and specific PROMs, which focus on specific symptoms, diseases, organs, body regions, or body functions. The establishment of a PROM instrument requires the fulfillment of methodological standards and ...


What Outcomes Are Important For Gout Patients? In-Depth Qualitative Research Into The Gout Patient Experience To Determine Optimal Endpoints For Evaluating Therapeutic Interventions, Sophi Tatlock, Katja Rudell, Charlotte Panter, Rob Arbuckle, Leslie R. Harrold, William J. Taylor, Tara Symonds 2017 Adelphi Values

What Outcomes Are Important For Gout Patients? In-Depth Qualitative Research Into The Gout Patient Experience To Determine Optimal Endpoints For Evaluating Therapeutic Interventions, Sophi Tatlock, Katja Rudell, Charlotte Panter, Rob Arbuckle, Leslie R. Harrold, William J. Taylor, Tara Symonds

Leslie R. Harrold

BACKGROUND AND OBJECTIVES: Characterized by sudden onset of severe joint pain, swelling, redness, and tenderness to touch, gout 'flare ups' have a substantial impact on quality of life (QoL). This research employed a patient-centered approach to explore the symptoms and impacts of gout, and assess the content validity of existing patient-reported outcomes (PROs). METHODS: Qualitative interviews were conducted with 30 US gout patients (non-tophaceous: n = 20, tophaceous: n = 10) and five expert rheumatologists. Each interview included both concept elicitation (CE) questioning to learn about the patient experience and cognitive debriefing to assess the content validity of three PRO instruments (HAQ-DI ...


Two Cases Of Lyme Arthritis In Winter In New England: A Case Series, Jennifer Baima, Lauren Woo 2017 University of Massachusetts Medical School

Two Cases Of Lyme Arthritis In Winter In New England: A Case Series, Jennifer Baima, Lauren Woo

Orthopedics and Physical Rehabilitation Publications and Presentations

Case Diagnosis: Lyme Arthritis

Case Description: Patient 1 is a 26 year old male who presented in March with severe right knee pain and swelling for two weeks. He had a similar episode a month prior, but it resolved. The second episode progressed with pain from knee to foot and numbness on top of the foot. He had no known history of tick bites, travel, or trauma, but endorsed contact with a dog. On physical exam, he had a right knee effusion with limited ROM, diffuse joint line tenderness, positive McMurray’s, and pain with ligamentous testing. Synovial fluid of ...


Total Joint Replacement Prehabilitation: A Feasibility Study, Jennifer Baima, Elizabeth Z. Li, Amanda Doodlesack, Mathew J. Most, Jeffrey Metzmaker, David C. Ayers 2017 University of Massachusetts Medical School

Total Joint Replacement Prehabilitation: A Feasibility Study, Jennifer Baima, Elizabeth Z. Li, Amanda Doodlesack, Mathew J. Most, Jeffrey Metzmaker, David C. Ayers

Orthopedics and Physical Rehabilitation Publications and Presentations

Objectives: Pre-operative physical therapy has been shown to reduce post-acute care service utilization. Shifting rehabilitation to the presurgical period, referred to as prehabilitation, could result in reduced recovery time and cost. Limited access to physical therapy may prevent patients from achieving the benefits, and a standard set of independent exercises may be an alternative. We aim to assess the feasibility of an independent exercise program as a pre-surgical intervention for total hip and knee replacement.

Design: Participants were taught two exercises for hip or knee arthritis at least one week prior to surgery and instructed to perform them independently at ...


Ipsilateral Lower Limb Weakness After Sarcoma Treatment: A Case Report, Jennifer Baima, Amanda Doodlesack, Jennifer LaFemina 2017 University of Massachusetts Medical School

Ipsilateral Lower Limb Weakness After Sarcoma Treatment: A Case Report, Jennifer Baima, Amanda Doodlesack, Jennifer Lafemina

Orthopedics and Physical Rehabilitation Publications and Presentations

Case Diagnosis: Our patient experienced worsening left foot neuropathy following chemotherapy and radiation treatment for sarcoma.

Case Description: A 24-year-old man underwent local resection of a 12cm x 8cm x 14.5cm rhabdomyosarcoma in the left vastus lateralis. Then, he was treated with vincristine for 40 weeks and radiation to the left lateral thigh with a maximum dose of 50.4 Gy. The sciatic nerve was outside the target area and received a lower dose. While undergoing chemotherapy, the patient experienced bilateral dysesthesias in his fingertips and feet. He had no history of neuropathy prior to treatment. After chemotherapy was ...


High-Speed Video Capture Of Anterior Cruciate Ligament Tear, Steven L. Cook, Devon T. Smith 2017 Brigham Young University

High-Speed Video Capture Of Anterior Cruciate Ligament Tear, Steven L. Cook, Devon T. Smith

Biomedical Engineering Western Regional Conference

High-speed Video Capture of Anterior Cruciate Ligament Tear


Prospects And Limitations Of Improving Skeletal Growth In A Mouse Model Of Spondyloepiphyseal Dysplasia Caused By R992c (P.R1192c) Substitution In Collagen Ii., Machiko Arita, Jolanta Fertala, Cheryl Hou, James Kostas, Andrzej Steplewski, Andrzej Fertala 2017 Thomas Jefferson University

Prospects And Limitations Of Improving Skeletal Growth In A Mouse Model Of Spondyloepiphyseal Dysplasia Caused By R992c (P.R1192c) Substitution In Collagen Ii., Machiko Arita, Jolanta Fertala, Cheryl Hou, James Kostas, Andrzej Steplewski, Andrzej Fertala

Department of Orthopaedic Surgery Faculty Papers

Skeletal dysplasias form a group of skeletal disorders caused by mutations in macromolecules of cartilage and bone. The severity of skeletal dysplasias ranges from precocious arthropathy to perinatal lethality. Although the pathomechanisms of these disorders are generally well defined, the feasibility of repairing established aberrant skeletal tissues that developed in the presence of mutant molecules is currently unknown. Here, we employed a validated mouse model of spondyloepiphyseal dysplasia (SED) that enables temporal control of the production of the R992C (p.R1192C) collagen II mutant that causes this disease. Although in our earlier studies we determined that blocking the expression of ...


What Outcomes Are Important For Gout Patients? In-Depth Qualitative Research Into The Gout Patient Experience To Determine Optimal Endpoints For Evaluating Therapeutic Interventions, Sophi Tatlock, Katja Rudell, Charlotte Panter, Rob Arbuckle, Leslie R. Harrold, William J. Taylor, Tara Symonds 2017 Adelphi Values

What Outcomes Are Important For Gout Patients? In-Depth Qualitative Research Into The Gout Patient Experience To Determine Optimal Endpoints For Evaluating Therapeutic Interventions, Sophi Tatlock, Katja Rudell, Charlotte Panter, Rob Arbuckle, Leslie R. Harrold, William J. Taylor, Tara Symonds

University of Massachusetts Medical School Faculty Publications

BACKGROUND AND OBJECTIVES: Characterized by sudden onset of severe joint pain, swelling, redness, and tenderness to touch, gout 'flare ups' have a substantial impact on quality of life (QoL). This research employed a patient-centered approach to explore the symptoms and impacts of gout, and assess the content validity of existing patient-reported outcomes (PROs).

METHODS: Qualitative interviews were conducted with 30 US gout patients (non-tophaceous: n = 20, tophaceous: n = 10) and five expert rheumatologists. Each interview included both concept elicitation (CE) questioning to learn about the patient experience and cognitive debriefing to assess the content validity of three PRO instruments (HAQ-DI ...


Enhancement Of Fracture Healing In The Rat, Modulated By Compounds That Stimulate Inducible Nitric Oxide Synthase: Acceleration Of Fracture Healing Via Inducible Nitric Oxide Synthase., R A Rajfer, A Kilic, Andrew S Neviaser, L M Schulte, S M Hlaing, J Landeros, M G Ferrini, E Ebramzadeh, S-H Park 2017 George Washington University

Enhancement Of Fracture Healing In The Rat, Modulated By Compounds That Stimulate Inducible Nitric Oxide Synthase: Acceleration Of Fracture Healing Via Inducible Nitric Oxide Synthase., R A Rajfer, A Kilic, Andrew S Neviaser, L M Schulte, S M Hlaing, J Landeros, M G Ferrini, E Ebramzadeh, S-H Park

Orthopaedic Surgery Faculty Publications

OBJECTIVES: We investigated the effects on fracture healing of two up-regulators of inducible nitric oxide synthase (iNOS) in a rat model of an open femoral osteotomy: tadalafil, a phosphodiesterase inhibitor, and the recently reported nutraceutical, COMB-4 (consisting of L-citrulline, Paullinia cupana, ginger and muira puama), given orally for either 14 or 42 days.

MATERIALS AND METHODS: Unilateral femoral osteotomies were created in 58 male rats and fixed with an intramedullary compression nail. Rats were treated daily either with vehicle, tadalafil or COMB-4. Biomechanical testing of the healed fracture was performed on day 42. The volume, mineral content and bone density ...


Orthopaedic Surgeon Density In West Virginia, Franklin D. Shuler, Grant S. Buchanan, Zachary Sanford, Milad Modarresi, James Timothy Reagan, Kelly Scott, Chad Fisher, Ali Oliashirazi 2017 Marshall University

Orthopaedic Surgeon Density In West Virginia, Franklin D. Shuler, Grant S. Buchanan, Zachary Sanford, Milad Modarresi, James Timothy Reagan, Kelly Scott, Chad Fisher, Ali Oliashirazi

Marshall Journal of Medicine

Abstract

West Virginia (WV) has many healthcare disparities and access barriers. For bone and joint disorders, WV has some of the highest rates of musculoskeletal problems, including the highest reported rate of adult arthritis in the nation (36.2%). We hypothesized that WV has one of the lowest Orthopaedic surgeon densities in the country, which can negatively impact the delivery of musculoskeletal care. Using the WV Board of Medicine practitioner databank, the Veterans Administration practitioner data, and national Orthopaedic surgeon census data, we demonstrated a considerably low Orthopaedic surgeon density in WV (7.71/100,000 population versus the national ...


Sports Medicine Potpourri, Marc I. Harwood, MD 2017 Thomas Jefferson University

Sports Medicine Potpourri, Marc I. Harwood, Md

Department of Family & Community Medicine Lectures, Presentations, Workshops

Objectives:

At the conclusion of this talk, the learner will be:

  • Thoroughly confused by the whirlwind of information presented
  • But...able to delve into any of the topics at greater length when time permits.

Presentation: 52:03

Audio for PowerPoint slides.


Educating Patients About Behavioral Interventions And Exercises For Musculoskeletal Lower Back Pain, Alex Jacobson 2017 University of Vermont College of Medicine

Educating Patients About Behavioral Interventions And Exercises For Musculoskeletal Lower Back Pain, Alex Jacobson

Family Medicine Block Clerkship, Student Projects

Low back pain (LBP) is a common problem which affects all genders and most ages. It results in considerable direct and indirect costs, and these costs are financial, workforce and social. The majority of lower back pain occurs due to a musculoskeletal etiology and often presents to the primary care physician. We worked with local physicians, chiropractors, physical therapists, and athletic trainers to develop exercises and behavioral modifications that patients can do to improve lower back pain symptoms.


Near-Complete Humerus Reconstruction In The Pediatric Patient With Vascularized Free Fibula Transfer., John Shuck, Benjamin C Wood, Christopher Zarella, Albert K Oh, Robert M Henshaw, Gary F Rogers 2016 George Washington University

Near-Complete Humerus Reconstruction In The Pediatric Patient With Vascularized Free Fibula Transfer., John Shuck, Benjamin C Wood, Christopher Zarella, Albert K Oh, Robert M Henshaw, Gary F Rogers

Surgery Faculty Publications

Vascularized free fibula transfer remains the gold standard for reconstruction of large segmental diaphyseal defects of the upper extremity. In the pediatric patient, before skeletal maturity, free fibula transfer with the fibular head provides an active physis for growth and an articular interface for glenohumeral joint reconstruction. Clinical and cadaveric studies have demonstrated that the vascular supply to the fibular head originates, in most cases, from the anterior tibial system. However, anatomical variation exists, and we report a case in which a vascularized fibula autograft including the physis was transferred on the peroneal artery in a 5-year-old patient with Ewing ...


Early Experience Of Dynamic Hip Screw With Spiral Blade And Locking Side Plate For The Stabilization Of Trochanteric Fractures., Akbar Jaleel Zubair, Rizwan Haroon Rashid, Marij Zahid, masood umer, Pervaiz Hashmi 2016 Aga Khan University

Early Experience Of Dynamic Hip Screw With Spiral Blade And Locking Side Plate For The Stabilization Of Trochanteric Fractures., Akbar Jaleel Zubair, Rizwan Haroon Rashid, Marij Zahid, Masood Umer, Pervaiz Hashmi

Department of Surgery

Abstract

OBJECTIVE:

To evaluate early experience with helical hip system in osteoporotic elderly patients with per-trochanteric fractures.

METHODS:

The retrospective study was conducted at Aga Khan University Hospital, Karachi, and comprised records of patients having low-velocity pertrochanteric fractures who were fixed with spiral blade Dynamic Helical Hip Systemfrom July to December 2014 and were followed up for a minimum of 3 months. Demographic variables and clinical outcomes were noted from the medical records whereas operative details were recorded from the operative note. Radiological variables and outcomes were assessed by viewing appropriate pre-operative, post-operative and follow-up radiographs.

RESULTS:

Of the 32 ...


Lamina Spreader Technique Improves Debridement Of Loose Bone And Cement In Total Knee Arthroplasty, Sinan E. Ozgur, Ali Oliashirazi, Grant S. Buchanan, Franklin D. Shuler 2016 Marshall University

Lamina Spreader Technique Improves Debridement Of Loose Bone And Cement In Total Knee Arthroplasty, Sinan E. Ozgur, Ali Oliashirazi, Grant S. Buchanan, Franklin D. Shuler

Franklin D. Shuler

A lamina spreader was introduced to the non-articulating, posterior aspect of the tibial and femoral components, and gentle distraction was applied to improve the inspection of the posterior compartment


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