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Development Of Takotsubo Cardiomyopathy In 46-Year-Old With Refractory Crohn's Disease, Margarita Pipinos, Andrea Klooz, Maria E. Tecos, Andrew Kamien

Graduate Medical Education Research Journal

Rampant autoimmune disease has the potential to ravage the entirety of the body in a systemic fashion. Rarely, it has been reported for Takotsubo cardiomyopathy develop as a result of refractory inflammatory bowel disease. Balancing the comprehensive cares required to support both the cardiovascular system and treat the underlying autoimmune condition care present unique challenges. Here, we describe a patient who developed late-onset Takotsubo cardiomyopathy after prolonged systemic stress as a result of uncontrolled Crohn’s disease. While this patient unfortunately did succumb to the disease process, it is our hope that highlighting these rare cases may progress care for future …

Isolated Rotational Dislocation Of The Talus: A Case Report, Tomas Holy, Nicholas Newcomb, Devin Maez, Christopher Paiz, Samer Kakish

Western Journal of Orthopaedics

A 46-year-old man sustained a closed pantalar dislocation in a high-speed motor vehicle ejection. The patient underwent closed reduction and splinting with subsequent open reduction and external fixation to ensure anatomic reduction of the tibiotalar, talonavicular, and subtalar joints, resulting in a pain free ankle with improving range of motion. In an effort to minimize the significantly morbid complications, such as avascular necrosis of the talus and rapid onset post-traumatic arthritis, treatment of closed pantalar dislocations should be performed in an emergent manner to minimize damage to the extensive articular surface and tenuous blood supply to the talus.

Chondroblastoma Of The Calcaneus Treated With Femoral Head Allograft Reconstruction For Subtalar Arthrodesis In A Skeletally Immature Patient: A Case Report, Benjamin B. Blanco, Ryan Dahlberg, David H. Chafey

Western Journal of Orthopaedics

Chondroblastomas are rare, benign, primary bone tumors most seen in men within their second decade of life in the epiphyseal/apophyseal region of long bones. Only a few cases of disease in the calcaneus have been reported previously, with treatment generally involving surgical curettage and local adjuvants. Recurrence rates can be as high as 38.0%, especially in a lesion near the physis or in skeletally immature patients. The authors present the case of a 14-year-old boy with active calcaneal chondroblastoma that was successfully treated with curettage, allograft reconstruction, and subtalar arthrodesis. The patient is now two years postoperative with no evidence …

Rehabilitation Medicine In Rural New Mexico And Beyond, Rebecca A. Dutton

Western Journal of Orthopaedics

No abstract provided.

Outcomes Of Hemiepiphysiodesis For Juvenile Hallux Valgus: A Systematic Review, Karim Gaber, Faran Chaudhry, Ihtisham Ahmad, Emmanuel Olaonipekun, Waleed Kishta

Western Journal of Orthopaedics

Juvenile hallux valgus (JHV) is a common deformity of the forefoot that may result in significant pain and discomfort. To correct JHV, percutaneous, or minimally invasive surgeries have become more popular than open surgeries due to reductions in morbidity. One of these procedures is percutaneous hemiepiphysiodesis. The aim of this study was to evaluate the efficacy of percutaneous hemiepiphysiodesis for JHV by investigating the available literature on the procedure.

In this systematic review, the authors’ search strategy identified 91 studies, but only five met the inclusion criteria. The identified studies included 76 patients and 132 feet. There was an improvement …

Change In Posterior Tibial Slope And Patellar Height During Medial Opening Wedge High Tibial Osteotomy: A Retrospective Cohort Study, Jessica A. Nelson, Brandon M. Painter, Dustin L. Richter, Jennifer S. Weaver, Robert C. Schenck

Western Journal of Orthopaedics

Background: Medial opening wedge high tibial osteotomy (MOWHTO) may be indicated for patients who have varus alignment, medial knee pain, and medial knee compartment osteoarthritis. Another indication for MOWHTO is in patients with a history of recurrent anterior cruciate ligament (ACL) deficiency or failed ACL reconstruction (ACLR) with varus alignment. Some patients have MOWHTO combined with a primary or revision ACLR.

Methods: This is a retrospective case series that was approved by the Institutional Review Board at the authors’ institution. The purpose of this series is to report on average coronal plane alignment, posterior tibial slope (PTS), and patellar height …

Does Matching Humeral Version In Anatomic Shoulder Arthroplasty Affect Postoperative Range Of Motion? A Pilot Study, Shane Johns, William Curtis, Nicholas Newcomb, Ryan Dahlberg, Christopher Shultz

Western Journal of Orthopaedics

Background: While considerable focus has been given to address glenoid morphology and version in anatomic total shoulder arthroplasty (TSA), there has been little attention paid to the potential impacts of humeral version on postoperative outcomes. The purpose of this study is to assess the impact of matching native humeral version on postoperative range of motion (ROM) after anatomic TSA.

Methods: All anatomic TSAs performed by a single surgeon between September 2021 and June 2023 were retrospectively reviewed. Patients undergoing TSA for fracture and/or revision TSA were excluded. This study group consisted of 20 patients whose native humeral version was measured …

Comparison Of Helicopter And Ground Interfacility Transport On Time-To-Treatment Of Isolated Open Fractures, Jerry Speight Grimes, Duke Appiah

Western Journal of Orthopaedics

Background: Helicopter emergency medical services have become an integral part of trauma systems. When appropriately utilized, helicopter transport can improve the outcomes of trauma patients. The objective of this study was to determine if helicopter transport for interfacility transfers was effective in reducing time-to-treatment for isolated open fractures in the setting of a rural Level I trauma center. The authors hypothesized that helicopter transportation of isolated open fractures would not reduce time to definitive fixation.

Methods: All patients treated with isolated open fractures over a four-year period at a Level I trauma center were identified. In this study, the authors …

Pediatric Body Mass Index (Bmi) And Distal Radius Fracture Incidence, Jessica Avila, Tyler Hough, Nikalus Skipp, Amber L. West, Deana Mercer

Western Journal of Orthopaedics

Background: The authors postulate that obesity in children increases the risk of distal radius fracture compared to children who are not obese. Because it is difficult to determine the population at risk, the authors observed the inverse of the rate of obesity in pediatric patients with distal radius fractures in an attempt to determine if there was a difference compared to national data on frequency of obesity in the pediatric population in general. If the rate of obesity was greater in distal radius fractures than the overall population, this would constitute evidence that obesity may increase the risk of distal …

Radiographic Identification And Treatment Prioritization Of Pediatric Elbow Fractures, Hoang M. Nguyen, Bryce Clinger, Casey Slattery, Selina R. Silva, Patrick Bosch

Western Journal of Orthopaedics

Background: Constituting approximately 15.0% of fractures, pediatric elbow fractures often require surgical intervention. Accurate diagnosis in pediatric patients is challenging, demanding proficient radiographic expertise. Initial diagnosis falls to emergency medicine (EM) physicians and pediatricians, who may lack sufficient radiographic training. Previous research by Shrader found a 58.0% accuracy in non-academic EM physicians for pediatric elbow fractures. The purpose of the study is to build on Shrader’s work and assess orthopaedic surgery (OS), pediatric, EM, and residents’ ability to accurately interpret pediatric elbow radiographs.

Methods: OS, EM, and pediatric residents at a Level 1 trauma center in an academic institution examined …

Neuroarthropathy And Workers’ Compensation Denials In Healthcare, Jerry Speight Grimes

Western Journal of Orthopaedics

Background: Neuroarthropathy is a complication of peripheral neuropathy commonly associated with diabetes mellitus. The actual trigger for a neuroarthropathy episode is unknown. If the inciting event occurred at work, causality of neuroarthropathy is difficult to determine.

Methods: In this study, the authors retrospectively reviewed workers’ compensation claims to identify patients with diabetes mellitus, peripheral neuropathy, and neuroarthropathy. The correlation between their health status and claims status was reported. The number of workers’ compensation denials for services already performed were compared between the groups.

Results: Over a five-year period, 412 patients were evaluated in a tertiary foot and ankle clinic with …

Cross-Tasking In Surgery: An Efficient Method To Perform Multiple Tasks In Parallel, Jacob Sanchez, Robert C. Schenck Jr., Lillian J. Schenck, Urvij Modhia, Gehron Treme, Samer Kakish, Deana Mercer, Daniel C. Wascher, Dustin L. Richter

Western Journal of Orthopaedics

Multitasking is defined as the ability to perform more than one task or activity simultaneously, which can be inefficient, unsafe, and should be avoided when applied to surgery. Cross-tasking is a concept where processes can be safely performed in parallel. The authors present cross-tasking as a useful approach to surgical procedural task subsets, timing of parallel tasks, and combining parallel tasks when performing a specific orthopaedic operation. The authors use the examples of an anterior cruciate ligament reconstruction and complex spinal deformity correction to review the pearls and pitfalls of models that manage multiple simultaneous surgical and educational tasks. This …

Full Issue, Arianna Medina

Western Journal of Orthopaedics

No abstract provided.

Reverse Palmaris Longus Involving Guyon’S Canal Causing Ulnar Nerve Compression, David Peberdy, Sameer Gujral

Western Journal of Orthopaedics

The authors present a case of reverse palmaris longus muscle (RPLM) with consequential compression of the ulnar nerve within Guyon’s canal. They report clinical findings, investigations, including magnetic resonance imagining and functional assessments, and intraoperative findings. The authors found improved sensory and motor function following excision of RPLM. There are few previous case reports regarding RPLM and concomitant compression of the ulnar nerve within Guyon’s canal.

Synovial Fluid Inflammatory Profiles Did Not Differ Between Isolated Anterior Cruciate Ligament And Multi-Ligament Knee Injuries, Cale A. Jacobs, Robert C. Schenck Jr., Leorrie A. Watson, Caitlin E.W. Conley, Darren L. Johnson, Austin V. Stone, Christian Lattermann, Dustin L. Richter

Western Journal of Orthopaedics

Background: Postoperative arthrofibrosis is more common following surgical treatment of multi-ligament knee injury (MLKI) than isolated anterior cruciate ligament (ACL) injury. It has been proposed that the increased prevalence of postoperative arthrofibrosis after MLKIs may be due to increased inflammation secondary to greater trauma to the joint. The purpose of this study was to compare synovial concentrations of pro-inflammatory and anti-inflammatory cytokines between patients with MLKI and ACL injuries.

Methods: Synovial fluid was aspirated from the operative knee at the time of surgery from 14 patients with MLKI and 10 patients with isolated ACL injury. Structures injured, the time between …

Why You Should Use The New Ota Open Fracture Classification (Ofc3), Thomas A. Decoster, Meir Marmor

Western Journal of Orthopaedics

Open fracture classification has traditionally used a modified Gustilo Classification (GOFC). There are many recognized problems with the Gustilo classification. The Orthopaedic Trauma Association (OTA) produced an open fracture Classification (OTA OFC) in 2010 to overcome problems with GOFC. However, it has not been widely adapted, partially because there are too many categories. The OTA OFC has proven to be more effective in identifying particular parameters that affect outcome and treatment for open fractures than GOFC. Numerous authors have called for a reconciliation of the two classifications. The OTA Classification Committee has proposed a modification called the OTA OFC3, which …

Back Matter, Arianna Medina

Western Journal of Orthopaedics

No abstract provided.

Front Matter, Arianna Medina

Western Journal of Orthopaedics

No abstract provided.

Long-Term Success In Managing Midfoot Lateral Column Arthritis: A Case Report, Damian Fountain, Cesar Cardenas, Nicholas Brady, Katherine Gavin, Richard Miller

Western Journal of Orthopaedics

The lateral column of the midfoot is crucial for midfoot mobility and foot stability. Although there are several nonoperative treatment options for arthritis that is isolated to the lateral column cuboid-metatarsal joints, there is a lack of consensus on the best operative intervention, given the rare nature of the disease. The patient in this case initially presented to clinic in 2007 with a significant history of lateral midfoot pain in the fourth and fifth metatarsal cuboid region. Despite nonoperative interventions, her symptoms progressed, and in January of 2009, she elected to undergo interpositional arthroplasty of left fourth and fifth metatarsal …

Echocardiographic Predictive Factors Of Worsening Outcome In Type 1 Cardiorenal Syndrome, Saoussen Antit, Sabrine Bousnina, Marwa Fathi, Ridha Fekih, Elhem Boussabeh, Lilia Zakhama

Journal of the Saudi Heart Association

Introduction: Type 1 cardiorenal syndrome (CRS) is defined as acute decompensated heart failure (AHF) leading to secondary acute kidney injury. Few studies have evaluated the reliability of transthoracic echocardiography (TTE) in assessing outcomes in patients with type 1 CRS. We sought to identify echocardiographic predictors of outcomes (death and rehospitalization) in patients with type 1 CRS. Methods: This was a prospective longitudinal monocentric study, conducted from December 2020 to December 2022 in the cardiology department of the Internal Security Forces Hospital in Marsa, Tunisia. 68 patients with type 1 CRS were included prospectively. Physical, biological, and echocardiographic data were collected …

The Gender Spectrum Of In-Hospital Survival Post Primary Percutaneous Coronary Intervention For St Elevation Myocardial Infarction: Exploring Age-Driven Trends, Iva Patel, Pooja Vyas, Karthik Natarajan, Kewal Kanabar, Vishal Sharma, Sharad Jain, Dinesh Joshi, Swati Dahiya, Siva Nagendra Borra

Journal of the Saudi Heart Association

Background: The study was aimed to evaluate gender difference and age & gender specific interaction of in-hospital outcomes of patients with ST elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods: This was a prospective cohort study of 1748 patients with STEMI undergoing primary PCI. The study was dichotomised according to gender to evaluate the difference in the outcome. The study was further stratified based on an age cut-off of 75 years to examine the age-specific gender relationship in survival outcomes. Independent variables for in-hospital mortality were analysed through logistic regression. Results: There were 314 (17.96%) females with …

Hemoadsorption With Cytosorb As Part Of A Strategy To Improve Outcomes In Patients On Extracorporeal Membrane Oxygenation, Ruzica Mrkonjic

The VAD Journal

The exposure of a patient’s blood to the non-endothelialized surface of the extracorporeal membrane oxygenation (ECMO) system results in the production of pro-inflammatory and anti-inflammatory cytokines. This imbalance in pro- and anti-inflammatory cytokines leads to inflammatory response syndrome, which contributes to edema, vasoplegia, and multiple organ failure among other complications. Hemoadsorption therapy, with the use of CytoSorb^® (CytoSorbents) has emerged as a well-accepted treatment option that helps control pro-inflammatory response and improve outcomes for patients on ECMO. However, studies have shown that the potential of hemoadsorption is controversial and that it is crucial for clinicians to weigh the pros …

Endothelial Dysfunction Linked To Ventricular Dysfunction In Children With Sickle Cell Disease, A 3d Speckle Tracking Study., Antoine Abdelmassih, Mervat Haroun, Rasha Abdelraouf Abdelaziz Afifi, Gehan Hussein, Manal Abdelhameed, Marina George Asaad, Heba Tarabeh, Nourhan Essam El Din Taha, Nourine Diab, Noura Shebl, Raghda Fouda, Marianne Edward Yassa, Mohamed Ghobashy, Hala Agha

Journal of the Saudi Heart Association

Background

Sickle Cell Disease (SCD) is not a hematologic disease that occurs in isolation; it results in multi-organ complications. There is growing evidence of vascular stiffness as its underlying cause.

This study aimed to investigate the relationship between endothelial stiffness and LV dysfunction in SCD patients and to explore its pathophysiology, particularly regarding the depletion of vasodilators such as Nitric Oxide (NO).

Methodology

32 patients with established criteria for SCD and 40 healthy control subjects were selected for this case-control study. Comprehensive clinical assessment and assessment of endothelial function using Brachial Flow-mediated dilation (FMD) were performed, along with serum NO …

Bilateral Corneal Perforations Due To Elder Neglect, Jaclyn Jordan, Katherine Selman, Richard Byrne

Journal of Geriatric Emergency Medicine

Introduction: Atraumatic corneal melting and perforation is a rare etiology of eye pain and visual loss in the Emergency Department (ED), and xerophthalmia from vitamin A deficiency is primarily described as a cause of blindness in pediatric patients.

Case: A 68-year-old female presented to the ED with worsening eye pain and months of clouding and vision loss. History was limited by cognitive impairment and was provided by spouse. On exam, she was found to have a body mass index of 13.7 kg/m², dry mucous membranes, purulent discharge from both eyes, and opacification and erosion of both corneas. She …

Knowledge And Attitude Of Lebanese Adults Towards Asthma In Beirut, Lebanon, Farah Hatem Haidar, Doaa Issa, Maha Aboul Ela, Karim Raafat

BAU Journal - Health and Wellbeing

Asthma, a serious global health problem, has been an area of interest due to its increasing prevalence, expanding treatment costs, and rising burden on patients and the community. Since asthma cannot be cured, clinical episodes can be prevented and controlled by adequate management and sufficient knowledge of the disease. Appropriate treatment may relieve asthma symptoms and improve quality of life. However, poor knowledge of asthma disease and medication use, misdiagnoses, misuse of inhalers and inadequate self-management of disease symptoms may have a greater impact on the disease process. Therefore, assessment of the population’s knowledge and attitude toward asthma is essential. …

Emergency Care Of An Older Adult With Complex Care Needs, Muhammad Adnan Khan, Himika Dalia, Michelle Dietz

Journal of Geriatric Emergency Medicine

In this case report, we demonstrate the application of a stepwise guiding approach for older adults with complex care needs who present to the emergency department. It also highlights the challenges encountered during the implementation of these principles, and sheds light on the factors affecting the management of complex older populations. This case report emphasizes the pressing need for the development of a standardized protocol tailored to emergency physicians, addressing the unique needs of complex-multimorbid older adults, and overcoming the system barriers in emergency care.

The Impacts Of The Low-Fodmap Diet On The Management Of Irritable Bowel Syndrome Symptoms: Possibilities, Feasibility, And Alternatives, Nicolas J. Jo, Carmen Ortega-Santos

FIU Undergraduate Research Journal

Irritable bowel syndrome (IBS) is a common gastrointestinal (GI) condition characterized by a myriad of GI symptoms (e.g., diarrhea, nutrient malabsorption) that vary in severity. Due to its complex and individual nature, there is no known cure for IBS, but many diets have been assessed for their viability in managing symptoms. The low-FODMAP diet has recently been investigated for its potential benefits for IBS patients. FODMAPs, or Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols are short- and medium-chain carbohydrates that are poorly absorbed in the small intestine and are prone to absorb water and ferment in the colon. Consumption of these …

In Football Players With Scaphoid Fractures, How Does Surgical Intervention Compare To A Conservative Intervention For The Outcomes Of Repair? A Critically Appraised Topic, Kaitlin Brun, Meggan Bartok, Caitlin Craig, Ally Smith

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

CLINICAL SCENARIO

Scaphoid injuries are common in high impact or high collision sports with 11% of all hand injuries and 60%-70% of all carpal injuries being attributed to the scaphoid bone. Athletes at the highest risk include males ages 20-24 years of age and those who participate in football, basketball, or ice hockey. Fracture of the scaphoid are often misdiagnosed which increase the chance of a nonunion fracture. Currently most scaphoid fractures are treated either conservatively or with surgical interventions. The increasing knowledge of this injury leads us to question the best treatment options for future football athletes.

Effectiveness Of Kinesio Tape In Treating Low Back Pain: A Critical Appraisal, Stacey Lansky, Sara Stiltner

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

CLINICAL SCENARIO

Low back pain is a musculoskeletal disorder that is expected to affect 80% of the population. ^2,7-8 There are several therapeutic interventions including modalities and rehabilitation exercises that have been used in standard treatment of low back pain to improve pain and disability. ^2,3,5,6,8,9 However, few studies have been done on the effects of Kinesio Tape (KT) on pain and disability in patients with low back pain. It should be a primary goal of clinicians treating patients with low back pain to understand if KT is an appropriate alternative intervention in treating pain and disability associated with low …

Athletic Trainers’ Knowledge And Perceived Ability Of Recognizing And Treating Panic Attacks, Caitlin Hill, Chyrsten Gessel, Jaclyn Tate

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

Mental health is a condition of mental wellness that enables people to manage life's stressors, develop their potential, study and work effectively, and give back to their communities. One mental health condition is anxiety. Anxiety is the expectation of a threat in the future. There are multiple subtypes of anxiety disorders, including panic disorder with or without agoraphobia, generalized anxiety disorder (GAD), social anxiety disorder (SAD), specific phobias, separation anxiety, and panic disorder. This study investigates the relationship between ATs' knowledge and their perceived ability to identify and treat panic attacks.