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A Murine Model For Developmental Dysplasia Of The Hip: Ablation Of Cx3cr1 Affects Acetabular Morphology And Gait., George J. Feldman, Arlene Offemaria, Hind Sawan, Javad Parvizi, Theresa A. Freeman 2017 Thomas Jefferson University

A Murine Model For Developmental Dysplasia Of The Hip: Ablation Of Cx3cr1 Affects Acetabular Morphology And Gait., George J. Feldman, Arlene Offemaria, Hind Sawan, Javad Parvizi, Theresa A. Freeman

Rothman Institute

BACKGROUND: Developmental dysplasia of the hip (DDH) is a debilitating condition whose distinguishing signs include incomplete formation of the acetabulum leading to dislocation of the femur, accelerated wear of the articular cartilage and joint laxity resulting in osteoarthritis. It is a complex disorder having environmental and genetic causes. Existing techniques fail to detect milder forms of DDH in newborns leading to hip osteoarthritis in young adults. A sensitive, specific and cost effective test would allow identification of newborns that could be non-invasively corrected by the use of a Pavlik harness. Previously, we identified a 2.5 MB candidate region on ...


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

Margaret Ciccolella

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.


Effects Of Revision Surgery On Grade Of Adverse Local Tissue Reaction Following Recall Of A Modular Hip Implant, Joseph F. Davies, Danielle M. Greer, Susan Truchan 2017 Aurora Advanced Orthopedics

Effects Of Revision Surgery On Grade Of Adverse Local Tissue Reaction Following Recall Of A Modular Hip Implant, Joseph F. Davies, Danielle M. Greer, Susan Truchan

Journal of Patient-Centered Research and Reviews

Background: The Stryker Rejuvenate modular hip implant device allows for greater versatility in matching a patient’s anatomy than conventional implants. Device recalls and in vivo metal hypersensitivity after total hip arthroplasty (THA) are common. However, recall of the Rejuvenate implant represents one of the largest recall volumes to date, highlighting our uncertainty regarding causes of device metal fretting/corrosion and adverse local tissue reaction (ALTR). While devices with metal-on-metal bearings historically were culprits for release of metal debris, more recently developed modular-neck devices add opportunity for adjacent metal components to rub together. With the Rejuvenate device, corrosion or fretting ...


Conference Proceedings: Aurora Scientific Day 2017, 2017 Aurora Health Care

Conference Proceedings: Aurora Scientific Day 2017

Journal of Patient-Centered Research and Reviews

This supplement includes select abstracts presented at the 43rd Annual Aurora Scientific Day research symposium on May 24, 2017. Aurora Scientific Day hosts a forum for original research conducted by faculty, fellows, residents, and other allied health professionals affiliated with Aurora Health Care, an integrated health system headquartered in Milwaukee, Wisconsin.


Effect Of Carbon Monoxide-Releasing Molecule-3 On The Severity Of Endothelial Dysfunction Due To Elevation Of Hydrostatic Pressure In An In Vitro Model Of Compartment Syndrome, Michel A. Taylor 2017 The University of Western Ontario

Effect Of Carbon Monoxide-Releasing Molecule-3 On The Severity Of Endothelial Dysfunction Due To Elevation Of Hydrostatic Pressure In An In Vitro Model Of Compartment Syndrome, Michel A. Taylor

Electronic Thesis and Dissertation Repository

Compartment syndrome (CS) is a surgical emergency caused by elevated pressure within a closed osseofascial compartment. It leads to microvascular dysfunction, limiting oxygen and nutrient delivery, gas exchange, resulting in cellular anoxia, muscle necrosis and cell death.

Currently, the only effective treatment is surgical fasciotomy. Recently, carbon monoxide (CO) delivered via carbon monoxide releasing molecule-3 (CORM-3) has been shown to improve microvascular perfusion and convey anti-inflammatory benefits in animal models of CS.

The contribution of elevated hydrostatic pressure (EHP) to the pathophysiology of CS was examined in an in vitro model of CS. We found that EHP led to increased ...


Suicidal Bus Bombing Of French Nationals In Pakistan: Physical Injuries And Management Of Survivors, Hasnain Zafar, Rifat Rehmani, Tabish Chawla, masood umer, Mohsin-e-Azam 2017 Aga Khan University

Suicidal Bus Bombing Of French Nationals In Pakistan: Physical Injuries And Management Of Survivors, Hasnain Zafar, Rifat Rehmani, Tabish Chawla, Masood Umer, Mohsin-E-Azam

Hasnain Zafar

Abstract BACKGROUND: Suicidal bombing is particularly devastating and an increasingly common form of terrorist violence. In this paper, we present an epidemiologic description of the physical injuries of patients who survived the suicidal bombing attack in the context of the limited medical resources of a developing nation. METHODS: The management of individual patients was reviewed from a preprinted trauma form. Information on the nature of injuries, operative management and hospital course was recorded and data analyzed using the Trauma Registry. RESULTS: Twelve survivors out of 36 bomb blast victims brought to the Aga Khan University Hospital were transferred from primary ...


Inhibition Of Apoptosis Signal-Regulating Kinase 1 Alters The Wound Epidermis And Enhances Auricular Cartilage Regeneration., Qian-Shi Zhang, Deepa S. Kurpad, My G. Mahoney, Marla J. Steinbeck, Theresa A. Freeman 2017 Thomas Jefferson University; Second Xiangya Hospital of Central South University

Inhibition Of Apoptosis Signal-Regulating Kinase 1 Alters The Wound Epidermis And Enhances Auricular Cartilage Regeneration., Qian-Shi Zhang, Deepa S. Kurpad, My G. Mahoney, Marla J. Steinbeck, Theresa A. Freeman

Department of Orthopaedic Surgery Faculty Papers

Why regeneration does not occur in mammals remains elusive. In lower vertebrates, epimorphic regeneration of the limb is directed by the wound epidermis, which controls blastema formation to promote regrowth of the appendage. Herein, we report that knockout (KO) or inhibition of Apoptosis Signal-regulated Kinase-1 (ASK1), also known as mitogen-activated protein kinase kinase kinase 5 (MAP3K5), after full thickness ear punch in mice prolongs keratinocyte activation within the wound epidermis and promotes regeneration of auricular cartilage. Histological analysis showed the ASK1 KO ears displayed enhanced protein markers associated with blastema formation, hole closure and regeneration of auricular cartilage. At seven ...


Sacral Fractures And Associated Injuries., Ricardo Rodrigues-Pinto, Mark F. Kurd, Gregory D. Schroeder, Christopher K. Kepler, James C. Krieg, Jörg H. Holstein, Carlo Bellabarba, Reza Firoozabadi, F Cumhur Oner, Frank Kandziora, Marcel F. Dvorak, Conor P. Kleweno, Luiz R. Vialle, S. Rajasekaran, Klause J. Schnake, Alexander R. Vaccaro 2017 Hospital de Santo António

Sacral Fractures And Associated Injuries., Ricardo Rodrigues-Pinto, Mark F. Kurd, Gregory D. Schroeder, Christopher K. Kepler, James C. Krieg, Jörg H. Holstein, Carlo Bellabarba, Reza Firoozabadi, F Cumhur Oner, Frank Kandziora, Marcel F. Dvorak, Conor P. Kleweno, Luiz R. Vialle, S. Rajasekaran, Klause J. Schnake, Alexander R. Vaccaro

Rothman Institute

STUDY DESIGN: Literature review.

OBJECTIVE: The aim of this review is to describe the injuries associated with sacral fractures and to analyze their impact on patient outcome.

METHODS: A comprehensive narrative review of the literature was performed to identify the injuries associated with sacral fractures.

RESULTS: Sacral fractures are uncommon injuries that result from high-energy trauma, and that, due to their rarity, are frequently underdiagnosed and mistreated. Only 5% of sacral fractures occur in isolation. Injuries most often associated with sacral fractures include neurologic injuries (present in up to 50% of sacral fractures), pelvic ring disruptions, hip and lumbar spine ...


National Football League Skilled And Unskilled Positions Vary In Opportunity And Yield In Return To Play After An Anterior Cruciate Ligament Injury., JaeWon Yang, Jonathan D. Hodax, Jason T. Machan, Eric S. Secrist, Wesley M. Durand, Brett D. Owens, Adam E.M. Eltorai, Christopher C. Dodson 2017 Brown University

National Football League Skilled And Unskilled Positions Vary In Opportunity And Yield In Return To Play After An Anterior Cruciate Ligament Injury., Jaewon Yang, Jonathan D. Hodax, Jason T. Machan, Eric S. Secrist, Wesley M. Durand, Brett D. Owens, Adam E.M. Eltorai, Christopher C. Dodson

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Anterior cruciate ligament (ACL) injuries pose a significant risk to the careers of players in the National Football League (NFL). The relationships between draft round and position on return to play (RTP) among NFL players are not well understood, and the ability to return to preinjury performance levels remains unknown for most positions.

PURPOSE: To test for differences in RTP rates and changes in performance after an ACL injury by position and draft round. We hypothesized that skilled positions would return at a lower rate compared to unskilled positions. We further hypothesized that early draft-round status would relate to ...


Evaluation Of Surgical Methods For Treatment Of Cubital Tunnel Syndrome - Statistical Perspectives, Ahmed Mohammed Morsy 2017 Assiut University, South Egypt Cancer Institute, Pediatric Oncology Department

Evaluation Of Surgical Methods For Treatment Of Cubital Tunnel Syndrome - Statistical Perspectives, Ahmed Mohammed Morsy

Dr/ Ahmed Mohammed Morsy

This commentary addresses strengths and weaknesses of the clinical trial study protocol designed by Liu et al., in particular with regard of the methodology, taking into consideration the commentary article "Assessing surgical methods for treatment of cubital tunnel syndrome - which is the best?" Our commentary emphasizes the importance of adjustment for known prognostic covariates, such as duration of symptoms and advanced age that have been negatively correlated with outcomes in previous studies. Subgroup analysis for the treatment groups of interest, namely moderate and severe cubital tunnel syndrome, which have previously shown conflicting differences in efficacy of surgical options is highly ...


A Prospective Randomized Study Analyzing Preoperative Opioid Counseling In Pain Management After Carpal Tunnel Release Surgery., Todd H. Alter, Asif M Ilyas 2017 Rothman Institute at the Thomas Jefferson University

A Prospective Randomized Study Analyzing Preoperative Opioid Counseling In Pain Management After Carpal Tunnel Release Surgery., Todd H. Alter, Asif M Ilyas

Rothman Institute

PURPOSE: Prescription opioid misuse has become increasingly prevalent in the United States. Preoperative opioid counseling has been proposed to decrease opioid consumption after surgery. This study aimed to evaluate the effect of preoperative opioid counseling on patients' pain experience and opioid consumption after carpal tunnel release (CTR) surgery.

METHODS: A prospective comparison of consecutive patients scheduled to undergo CTR surgery was conducted. Patients were randomized to receive either formal preoperative opioid counseling or no counseling. All operations were performed with the same miniopen CTR surgical technique, and the same number of opioids were prescribed after surgery. Daily opioid pill consumption ...


Unilateral Heat Accelerates Bone Elongation And Lengthens Extremities Of Growing Mice, Maria A. Serrat, Thomas J. Schlierf, Morgan L. Efaw, Franklin D. Shuler, Justin Godby, Laura M. Stanko 2017 Marshall University

Unilateral Heat Accelerates Bone Elongation And Lengthens Extremities Of Growing Mice, Maria A. Serrat, Thomas J. Schlierf, Morgan L. Efaw, Franklin D. Shuler, Justin Godby, Laura M. Stanko

Franklin D. Shuler

Linear growth failure results from a broad spectrum of systemic and local disorders that can generate chronic musculoskeletal disability. Current bone lengthening protocols involve invasive surgeries or drug regimens, which are only partially effective. Exposure to warm ambient temperature during growth increases limb length, suggesting that targeted heat could noninvasively enhance bone elongation. We tested the hypothesis that daily heat exposure on one side of the body unilaterally increases femoral and tibial lengths. Mice (N = 20) were treated with 40 °C unilateral heat for 40 min/day for 14 days post-weaning. Non-treated mice (N = 6) served as controls. Unilateral increases ...


Intra And Inter-Rater Reliability And Convergent Validity Of Fit-Hansa In Individuals With Grade П Whiplash Associated Disorder, Michael Pierrynowski, Colleen McPhee, Saurabh Mehta, Joy C. MacDermid, Anita Gross 2017 Marshall University

Intra And Inter-Rater Reliability And Convergent Validity Of Fit-Hansa In Individuals With Grade П Whiplash Associated Disorder, Michael Pierrynowski, Colleen Mcphee, Saurabh Mehta, Joy C. Macdermid, Anita Gross

Saurabh Mehta

BACKGROUND: Whiplash-Associated Disorders (WAD) are common following a motor vehicle accident. The Functional Impairment Test - Hand, and Neck/Shoulder/Arm (FIT-HaNSA) assesses upper extremity physical performance. It has been validated in patients with shoulder pathology but not in those with WAD.

OBJECTIVES: Establish the Intra and inter-rater reliability and the known-group and construct validity of the FIT-HaNSA in patients with Grade II WAD (WAD2).

METHODS: Twenty-five patients with WAD2 and 41 healthy controls were recruited. Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI), Disabilities of the Arm, Shoulder and Hand (DASH), cervical range of motion (CROM), and FIT-HaNSA were ...


Patient-Reported Disability Measures Do Not Correlate With Electrodiagnostic Severity In Carpal Tunnel Syndrome., Jacob E Tulipan, Kevin F F. Lutsky, Mitchell G. Maltenfort, Mitchell K. Freedman, Pedro Beredjiklian 2017 Thomas Jefferson University

Patient-Reported Disability Measures Do Not Correlate With Electrodiagnostic Severity In Carpal Tunnel Syndrome., Jacob E Tulipan, Kevin F F. Lutsky, Mitchell G. Maltenfort, Mitchell K. Freedman, Pedro Beredjiklian

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Electrophysiologic studies including electromyography and nerve conduction studies play a role in the evaluation of carpal tunnel syndrome (CTS), despite evidence that these studies do not correlate with CTS-specific symptom scores. There is a lack of evidence comparing electrophysiologic data with general measures of function.

METHODS: Fifty patients presenting for CTS treatment over an 8-month period were analyzed retrospectively. All patients completed surveys including the Quick Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH) and the Medical Outcomes Study 12-Item Short-Form Survey [(physical component summary 12, mental component summary (MCS-12)]. Electromyography and nerve conduction studies were performed on ...


Improving The Pharmacologic Management Of Patients After Osteoporotic Hip Fractures, Joseph Klaus, Milad Modarresi, Rodrigo Aguilar, Nasreen BenHamed, Franklin D. Shuler 2017 Marshall University

Improving The Pharmacologic Management Of Patients After Osteoporotic Hip Fractures, Joseph Klaus, Milad Modarresi, Rodrigo Aguilar, Nasreen Benhamed, Franklin D. Shuler

Franklin D. Shuler

Abstract

Background

Osteoporotic hip fractures have become an increasingly common healthcare burden with significant morbidity and mortality in the geriatric population. Pharmacological management of the underlying osteoporosis is critical. Our objective is to determine the percentage of patients older than 65 who receive pharmacologic treatment of osteoporosis within six months after a fragility fracture at Cabell Huntington Hospital.

Methods

Data was extracted from medical records for patients age 65 or older who sustained a hip fracture during June 2013 - March 2015. Patients who received any form of pharmacologic treatment within six months after their fractures were identified. All analyses were ...


Trauma Team Activation For Geriatric Trauma At A Level Ii Trauma Center: Are The Elderly Under-Triaged?, Grant S. Buchanan, Daniel Scott Kahn, Harry Burke, Brian Czarkowski, Richard Boe, Milad Modarresi, Franklin D. Shuler 2017 Marshall University

Trauma Team Activation For Geriatric Trauma At A Level Ii Trauma Center: Are The Elderly Under-Triaged?, Grant S. Buchanan, Daniel Scott Kahn, Harry Burke, Brian Czarkowski, Richard Boe, Milad Modarresi, Franklin D. Shuler

Franklin D. Shuler

Abstract

Geriatric patients often sustain life-threatening injuries from minor trauma. A growing body of research suggests that these patients are often under-triaged in the emergency setting.The purpose of this research was to evaluate whether or not geriatric trauma patients are under-triaged at a community based level II trauma center.

1434 trauma patients over the age of 65 presenting from 2010-2015 were retrospectively reviewed from the Cabell Huntington Hospital trauma registry and analyzed for age, gender, arrival type, ED response, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), injury cause, ICD-9 diagnosis codes, and mortality. Under-triage and over-triage rates were ...


Improving The Pharmacologic Management Of Patients After Osteoporotic Hip Fractures, Joseph Klaus, Milad Modarresi, Rodrigo Aguilar, Nasreen BenHamed, Franklin D. Shuler 2017 Marshall University

Improving The Pharmacologic Management Of Patients After Osteoporotic Hip Fractures, Joseph Klaus, Milad Modarresi, Rodrigo Aguilar, Nasreen Benhamed, Franklin D. Shuler

Marshall Journal of Medicine

Abstract

Background

Osteoporotic hip fractures have become an increasingly common healthcare burden with significant morbidity and mortality in the geriatric population. Pharmacological management of the underlying osteoporosis is critical. Our objective is to determine the percentage of patients older than 65 who receive pharmacologic treatment of osteoporosis within six months after a fragility fracture at Cabell Huntington Hospital.

Methods

Data was extracted from medical records for patients age 65 or older who sustained a hip fracture during June 2013 - March 2015. Patients who received any form of pharmacologic treatment within six months after their fractures were identified. All analyses were ...


Trauma Team Activation For Geriatric Trauma At A Level Ii Trauma Center: Are The Elderly Under-Triaged?, Grant S. Buchanan, Daniel Scott Kahn, Harry Burke, Brian Czarkowski, Richard Boe, Milad Modarresi, Franklin D. Shuler 2017 Marshall University

Trauma Team Activation For Geriatric Trauma At A Level Ii Trauma Center: Are The Elderly Under-Triaged?, Grant S. Buchanan, Daniel Scott Kahn, Harry Burke, Brian Czarkowski, Richard Boe, Milad Modarresi, Franklin D. Shuler

Marshall Journal of Medicine

Abstract

Geriatric patients often sustain life-threatening injuries from minor trauma. A growing body of research suggests that these patients are often under-triaged in the emergency setting.The purpose of this research was to evaluate whether or not geriatric trauma patients are under-triaged at a community based level II trauma center.

1434 trauma patients over the age of 65 presenting from 2010-2015 were retrospectively reviewed from the Cabell Huntington Hospital trauma registry and analyzed for age, gender, arrival type, ED response, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), injury cause, ICD-9 diagnosis codes, and mortality. Under-triage and over-triage rates were ...


Age-Dependent Changes In The Articular Cartilage And Subchondral Bone Of C57bl/6 Mice After Surgical Destabilization Of Medial Meniscus, Henry Huang, Jordan D. Skelly, David C. Ayers, Jie Song 2017 University of Massachusetts Medical School

Age-Dependent Changes In The Articular Cartilage And Subchondral Bone Of C57bl/6 Mice After Surgical Destabilization Of Medial Meniscus, Henry Huang, Jordan D. Skelly, David C. Ayers, Jie Song

Jie Song

Age is the primary risk factor for osteoarthritis (OA), yet surgical OA mouse models such as destabilization of the medial meniscus (DMM) used for evaluating disease-modifying OA targets are frequently performed on young adult mice only. This study investigates how age affects cartilage and subchondral bone changes in mouse joints following DMM. DMM was performed on male C57BL/6 mice at 4 months (4 M), 12 months (12 M) and 19+ months (19 M+) and on females at 12 M and 18 M+. Two months after surgery, operated and unoperated contralateral knees were harvested and evaluated using cartilage histology scores ...


Direct-To-Patient Pro Collection To Support Quality Improvement In Tjr, Hua Zheng, Celeste A. Lemay, Wenyun Yang, Patricia D. Franklin 2017 University of Massachusetts Medical School

Direct-To-Patient Pro Collection To Support Quality Improvement In Tjr, Hua Zheng, Celeste A. Lemay, Wenyun Yang, Patricia D. Franklin

Celeste A. Lemay

Introduction: Patient-reported outcomes (PROs) are widely used in orthopedic clinical research to evaluate quality of care. However, it is difficult to capture complete post-operative PRO data through surgeon office visits. The UK and Sweden collect post-TJR PRO measures directly from patients in their homes. We compared two US post-operative PRO collection processes- PROs in clinic at scheduled office visits and direct-to-patient collection, to evaluate timing and completeness of both approaches.

Methods: At a large TJR center that has collected PROs at office visits routinely for years, post-TJR patients complete a PRO survey on a computer at follow-up clinic visits. In ...


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