Digital Commons Network^™

Management Of Periprosthetic Humeral Fractures Following Shoulder Arthroplasty, Akshay Khanna

Bone Bulletin

Introduction Since the introduction of reverse total shoulder arthroplasty (RTSA) in 2004, the total incidence of primary total shoulder arthroplasties in the United States has doubled to over 30 cases per 100,000 persons.^1,2 Despite overall complication rates decreasing with the advancement of novel techniques and implant designs, there are rising concerns regarding the frequency of certain complications including glenohumeral instability, rotator cuff tearing, and periprosthetic fracture.^3,4 Glenoid fractures are relatively rare, occurring at a rate of 1.4% in one national registry study.^19,20 The risk of periprosthetic humeral fracture, however, is of particular concern because of how devastating …

Revolutionizing Spine Surgery: The Potential Role Of Ai In Enhancing Surgical Workflow And Patient Outcomes, Samuel Ezeonu

Bone Bulletin

Introduction

With the growing incidence of degenerative spine pathology¹, surgeons have been tasked to treat more patients than ever. According to Mani et al., the number of single and multilevel fusion procedures are both projected to double over the next 25 years.² In light of this trend, several strategies have been proposed to reduce the resultant burden placed on hospitals and surgeons, while maintaining optimal standards of care. Namely, the use of artificial intelligence (AI) is a growing field that has greatly increased in the last decade. AI has the potential to relieve the cognitive workload placed …

The Future Of Robot-Assisted Surgery In Foot And Ankle Procedures, Sam Duggan

Bone Bulletin

Robot-assisted surgeries are becoming common in most fields of orthopaedics by providing increased accuracy and precision, reducing revision procedures.^1,2 Surgeons specializing in hip and knee, and more recently, spine, have seen tremendous increases in the use of robotics. Still, foot and ankle surgery has had little to no adoption of robotics due to the complex foot and ankle anatomy, in addition to small operating windows; however, usage in spine surgery may be a strong indicator of future use in foot and ankle surgery, as spine surgery similarly requires extreme precision in small operating spaces, with the added benefit of …

Exploring Robotic-Assisted Total Knee Arthroplasty, Sahil Shah

Bone Bulletin

Background and Introduction of Total Knee Arthroplasty

Within the field of orthopedics, joint replacements rank amongst the most common procedures. Among those, total knee arthroplasty (TKA) is the most commonly conducted joint replacement procedure at approximately 51.02% of arthroplasties between 2012 and 2022.¹ Annually, the American Academy of Orthopedic Surgeons estimates more than 700,000 TKAs are performed within the United States.² The procedure was introduced in 1968 to relieve severe joint pain and stiffness, as well as restore mobility in patients suffering from “end-stage degenerative knee osteoarthritis” or rheumatoid arthritis.³ TKAs revolutionized the treatment plan for patients …

Challenges And Concerns Of Artificial Intelligence In Shoulder And Elbow, Claude J. Regis

Bone Bulletin

Background

Artificial intelligence (AI) is rapidly transforming shoulder and elbow surgery, driving significant advancements across various domains. Currently, AI is enhancing diagnostic accuracy through imaging-based analysis, predictive modeling of clinical outcomes, implant identification, and automated image segmentation.^1,2 AI-driven personalized treatment plans are also anticipated to optimize patient care by tailoring interventions based on individual data analysis.³ Additionally, deep learning algorithms have been developed to automatically classify large sets of preoperative and postoperative radiographs in the setting of shoulder arthroplasty.⁴ These technologies, combined with AI, could revolutionize surgical training and intraoperative guidance, offering real-time data and enhanced visualization. …

Foreword, Alan S. Hilibrand

Bone Bulletin

As the Director of Undergraduate medical education for the Department of Orthopedic Surgery at the Sidney Kimmel Medical College, I am happy to once again oversee the third annual issue of the Bone Bulletin. Through the activities of the DePalma Orthopaedic Society, medical students at SKMC have an excellent venue to learn about orthopaedic surgery, and through articles in this publication our surgeons at Rothman Orthopaedics have enthusiastically mentored younger students interested in the field of orthopedic surgery. The DePalma leadership has worked hard on many initiatives in recent years: providing forums for orthopaedic faculty to speak about their …

Editors' Note, Liam Gibbons, Amit Syal

Bone Bulletin

We are thrilled to introduce the third edition of the Bone Bulletin, DePalma Orthopaedic Society’s student-run, non-peer reviewed journal for Sidney Kimmel Medical College (SKMC) students. The journal aims to offer an additional avenue for medical students to engage with orthopaedics in medical school. Through the 1-on-1 mentorship with physicians from the Rothman Orthopaedic Institute, students gain hands-on experience writing about and directly engaging with current orthopaedic research and developments.

After each edition, it’s been exciting to see the journal continue to grow, with increasing numbers of students eager to get involved. This year, we are proud to announce …

A Sad And Untimely Loss Of A (Gental) Giant Within Our Profession, Our Lives, Our Hearts, Richard A. Mufson

SFDDA Newsletter

Editorial feature from lead editor, Dr. Richard Mufson

The 7 Habits Of Highly Effective Dentists: Habit 6 "Synergize", Mark Limonsani

SFDDA Newsletter

Series based on Steven Covey's "The Seven Habits of Highly Effective People" seeks to inspire and guide readers on their journey to personal and professional excellence. This article focuses on the sixth habit, "Synergize."

Sfdda Newsletter Fall 2023

SFDDA Newsletter

SFDDA Newsletter includes regular columns with regional news impacting the South Florida District membership including: columns from the President and editor, feature articles relating to the field of dentistry, association events and upcoming activities, component news, continuing education opportunities, and classifieds.

President's Message

SFDDA Newsletter

Monthly update from Dr. Tim Franklin, DDS with details of recent events, upcoming activities and news from the association.

Sfdda Newsletter Spring 2023

SFDDA Newsletter

SFDDA Newsletter includes regular columns with regional news impacting the South Florida District membership including: columns from the President and editor, feature articles relating to the field of dentistry, association events and upcoming activities, component news, continuing education opportunities, and classifieds.

Sfdda Newsletter Winter 2023

SFDDA Newsletter

SFDDA Newsletter includes regular columns with regional news impacting the South Florida District membership including: columns from the President and editor, feature articles relating to the field of dentistry, association events and upcoming activities, component news, continuing education opportunities, and classifieds.

Sfdda Newsletter Fall 2022

SFDDA Newsletter

SFDDA Newsletter includes regular columns with regional news impacting the South Florida District membership including: columns from the President and editor, feature articles relating to the field of dentistry, association events and upcoming activities, component news, continuing education opportunities, and classifieds.

Sfdda Newsletter Summer 2022

SFDDA Newsletter

SFDDA Newsletter includes regular columns with regional news impacting the South Florida District membership including: columns from the President and editor, feature articles relating to the field of dentistry, association events and upcoming activities, component news, continuing education opportunities, and classifieds.

Sfdda Newsletter Spring 2022

SFDDA Newsletter

SFDDA Newsletter includes regular columns with regional news impacting the South Florida District membership including: columns from the President and editor, feature articles relating to the field of dentistry, association events and upcoming activities, component news, continuing education opportunities, and classifieds.

The 7 Habits Of Highly Effective Dentists: Habit 5 "Seek First To Understand, Then To Be Understood.", Mark Limonsani

SFDDA Newsletter

Series based on Steven Covey's "The Seven Habits of Highly Effective People" seeks to inspire and guide readers on their journey to personal and professional excellence. This article focuses on the fifth habit of building understanding.

President's Message

SFDDA Newsletter

Monthly update from Dr. Tim Franklin, DDS with details of recent events, upcoming activities and news from the association.

Medication Access And Training Expandsion (Mate) Act, Richard A. Mufson

SFDDA Newsletter

Article provides helpful answers in regards to the new eight hour CE requirement for DEA license renewal.

Sfdda Newsletter Summer 2023

SFDDA Newsletter

SFDDA Newsletter includes regular columns with regional news impacting the South Florida District membership including: columns from the President and editor, feature articles relating to the field of dentistry, association events and upcoming activities, component news, continuing education opportunities, and classifieds.

Implementing A Sustainability Approach By Converting Plastic Bottle Waste From A Mischievous Substance To A Beneficial Material By Means Of Zero Residue Level Concept, Younus Mohammed Abed, Fatima Allawi, Shahad Mudhafar Ali, Salem Jawad Alhamd, Thekra Atta Ibrahim, Mohammed Nsaif Abbas

Karbala International Journal of Modern Science

Plastic waste represents a serious environmental and health hazard due to its non-biodegradability and toxic leachates. This study investigates the potential conversion of plastic waste into a sustainable raw material for producing a useful substance. This investigation focuses on repurposing PET beverage bottles—a major contributor to microplastic pollution—into high-value activated carbon (AC) for water treatment, aligning with circular economy principles. The chemical preparation method for AC using phosphoric acid as an activating agent was evaluated. Results demonstrated the successful conversion of 68% of plastic waste into AC under the following conditions: pyrolysis temperature of 700°C, pyrolysis time of 7 hours, …

Deep Neck Space Infection As A Complication Of Transesophageal Echocardiogram For Atrial Flutter Ablation, Anish K Shrestha, Naffa Faisal, Kanchana Bali, Nadine Safi, Maria E. Mesalles, Nahar Saleh

Journal of Community Hospital Internal Medicine Perspectives

Transesophageal echocardiography is a relatively safe procedure; however, there are rare complications associated with it. Multiple attempts during TEE can lead to injury of hypopharyngeal or parapharyngeal wall leading to an infection. Here, we describe a case of hypopharyngeal-parapharyngeal abscess resulting from multiple TEE attempts during cardioversion leading to a prolonged hospital course.

A Rare, Cephalosporin-Induced Rash: Acute Generalized Exanthematous Pustulosis, Mark A. Colantonio, Danielle Sblendorio, Elizabeth Hart, Vincent Melemai, Joshua Wiley

Journal of Community Hospital Internal Medicine Perspectives

Acute generalized exanthematous pustulosis is an uncommon cause of rash, typically presenting with pustules with an erythematous base and associated skin-peeling. Frequently caused by medications, including penicillins and quinolones, cephalosporins are rarely reported as an offending agent. Here, we present a case of rare acute generalized exanthematous pustulosis secondary to recent cephalosporin use presenting to our rural healthcare facility. We aim to raise awareness of this unusual rash secondary to cephalosporin use.

First Report Of Successful Rituximab Therapy In Idiopathic Sclerosing Mesenteritis, Indira Acharya, Carey Field, Mary E. Clark

Journal of Community Hospital Internal Medicine Perspectives

Sclerosing mesenteritis (SM) is a rare idiopathic fibroinflammatory disorder of the bowel mesentery adipose tissue.While the use of rituximab has been documented in IgG4-related SM, its effectiveness in idiopathic, IgG4-unrelatedSM remains unknown. We present a case of idiopathic SM successfully managed with rituximab, suggesting thatthis treatment may be an option for patients who either have contraindications to or have not responded to current first-line therapies.

Blastomycosis In A Renal Transplant Recipient: A Rare Encounter In Rural Appalachia, Khawaja O. Omar, William Sebastian, Suzanne Kemper

Journal of Community Hospital Internal Medicine Perspectives

Background: Blastomycosis is a fungal infection caused by Blastomyces species, which are thermally dimorphic fungi endemic to the midwestern, south-central, and southeastern United States (US). Organ transplant patients are at risk of infection due to long-term immunosuppressive therapy. We present a unique case of blastomycosis in a renal transplant patient residing in a non-endemic region of Appalachia.

Case Report: A 67-year-old patient with history of tobacco use, atrial fibrillation, type 2 diabetes, hyperlipidemia, and bilateral deceased donor kidney transplantation (DDKT) in 2021, presented to Charleston Area Medical Center’s (CAMC), Charleston WV, Emergency Department (ED) for fever and night sweats. Initial …

Late Onset Malignant Metastatic Transformation Of Benign Pheochromocytoma, Maha Zafar, Reshly Mary Rajan, Manaswini Krishnakumar, Aswanth Reddy

Journal of Community Hospital Internal Medicine Perspectives

Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors arising from adrenal medulla and extra-adrenal paraganglia. Metastatic pheochromocytomas, pose diagnostic and therapeutic challenges due to their atypical presentations and potential for malignant transformation years after primary tumor resection. We report a case of 61-year-old woman who presented with intermittent cough, shortness of breath, and elevated blood pressure 6 years after resection of primary adrenal pheochromocytoma. Imaging revealed bilateral pulmonary nodules, a retroperitoneal mass, and L4 vertebral involvement, raising suspicion for metastatic pheochromocytoma. Elevated serum metanephrines and normetanephrines, alongside tissue biopsy and MIBG imaging, confirmed diagnosis. Germline genetic testing did not reveal …

Walking Pneumonia - Not Always So Timid A Case Of Severe Ards Due To Fulminant Mycoplasma Pneumonia, Tharun Shyam, Momna Noor, Yan Naing Tun, Saumya Nanda, Omair Khan, Ravikaran Patti

Journal of Community Hospital Internal Medicine Perspectives

Mycoplasma pneumoniae pneumonia (MPP) most commonly presents as bronchitis or as a self-limited ‘walking’ community acquired pneumonia. A fulminant form of MPP may occur in 0.5% to 2% of patients and is characterized by rapidly progressive respiratory failure and Acute respiratory distress syndrome (ARDS). Our case highlights the importance of considering fulminant MPP as a cause of ARDS, especially in the young adult and middle-aged population. We review the current literature and management principles of this rare disease with an emphasis on antibiotic stewardship and corticosteroid therapy. Further research is needed to better understand patterns of antibiotic resistance and to …

Beyond Atrial Fibrillation And Heart Failure: Ibrutinib-Induced Pericardial Effusion, Anaiya Singh, Kathryn Ruckstuhl, Viraj Panchal, Poornima Ramadas

Journal of Community Hospital Internal Medicine Perspectives

Ibrutinib, a Bruton’s tyrosine kinase inhibitor, has transformed the management of various hematological malignancies. However, its association with cardiovascular toxicities, particularly atrial fibrillation (AF), hypertension, and heart failure (HF), has raised clinical concerns. Pericardial effusion, though rare, is an emerging complication warranting attention. We present the case of a 62-year-old male with lymphoplasmacytic lymphoma, initially treated with Bendamustine and Rituximab, which was discontinued due to significant neutropenia. Ibrutinib therapy was initiated, leading to a partial response at three months. Approximately ten months into ibrutinib treatment, the patient developed new-onset dyspnea, palpitations, and dizziness. ECG revealed AF with rapid ventricular response, …

Acute Esophageal Necrosis: A Case Series Of Two Critically Ill Patients, Shadan Mehraban, Jonathan London, Leilah Tisheh, Jiya Mulayamkuzhiyil, Mario Mekhail, Zubin Tharayil, Chris Lascarides, Pranay Srivastava, Prakash Viswanathan

Journal of Community Hospital Internal Medicine Perspectives

Acute esophageal necrosis (AEN) is a rare syndrome, characterized by extensive circumferential necrosis of the esophageal mucosa at the gastroesophageal junction. AEN carries significant morbidity and mortality, and early recognition is crucial for management. We present a case series of AEN in two critically ill patients, one who presented with coffee ground emesis and diabetic ketoacidosis (DKA) and the other one who presented with upper gastrointestinal bleed in the setting of malignancy and concurrent infection with active antibiotic use. Prompt diagnosis and management of both AEN and its underlying causes are crucial to improve patient outcomes.

Abdominal Necrotizing Fasciitis Secondary To Perforated Colon Cancer, Anirudra Devkota, Anish Shrestha, Mariah M. Bilalaga, Greeshma Gaddipati, Christopher J. Haas

Journal of Community Hospital Internal Medicine Perspectives

Necrotizing Fasciitis (NF) is a severe, potentially fatal soft tissue infection leading to death of muscles, fascia, and surrounding tissue. Perforated colon cancer (CC) is an exceedingly uncommon cause of NF. Here, we present a case of NF secondary to perforated colon cancer. This case emphasizes the significance of prompt identification, aggressive surgical excision of affected tissue, and consideration of rare, yet potentially fatal underlying etiologies in the management of NF as well as underscores the importance of CC screening to prevent devastating complications and mortality