Medicine and Health Sciences Commons^™

Content Table

LATIN Neurosurgery Journal

No abstract provided.

Herpes Simplex Keratitis After Prk, Joshua Graf Od

Optometric Clinical Practice

Background: Herpes simplex virus (HSV) is a double stranded DNA virus that infects much of the world’s population. The World Health Organization estimates 67% of people under the age of 50 have HSV-1 and 11% of people under the age of 50 have HSV-2. While most systemic infections remain inactive and do not cause symptoms, the activation and appearance of ocular HSV can be a destructive and vision-threatening issue. HSV keratitis can be epithelial, stromal or a combination. Patients who have recently undergone photorefractive keratectomy (PRK) have a higher risk of HSV keratitis. Because of this, HSV keratitis should be …

An Unusual Case Of Cardiogenic Shock: Coronary Artery Vasospasms, Amanda Bergeron, Maks Mihalj

Journal of Shock and Hemodynamics

Coronary artery vasospasms may occur in one or multiple coronary arteries, typically causing transient chest pain or angina. Although rare, it can lead to lethal cardiac arrhythmias, cardiac arrest, or cardiogenic shock and is often misdiagnosed. We report a case of a young man with an atypical presentation of generalized coronary vasospasm leading to cardiac arrest and subsequent cardiogenic shock. The patient required support with veno-arterial extracorporeal membrane oxygenation and Impella. We discuss the risk factors, diagnosis, and treatment of this rare condition.

Full Issue: Volume 2, Issue 1 - April 2024

Bone Bulletin

i - Editors’ Note by Ari Clements & Amit Syal

ii - Foreword by Dr. Alan Hilibrand

7 - Exploring Approaches to Treatment of Musculoskeletal Injuries by Catherine Alvaro

9 - A Spotlight on the Various Subspecialties of Orthopedic Surgery by Ryan Garemani

14 - Exploring the Importance of Implant Selection in Total Hip Arthroplasty by John Czarnecki

16 - Revolutionizing Orthopaedics: Exploring the Therapeutic Potential of Stem Cells by Harrison Fellheimer

18 - Shoulder Arthroplasty in Patients with Inflammatory Arthritis: Preoperative and Perioperative Management of Disease Modifying Anti-Rheumatic Drug Therapy by Daniel Kwak

22 - The Role of Psychological …

Redefining Recovery: Multimodal Analgesics And Tranexamic Acid In Orthopedic Surgery, Elijah Hoffman

Bone Bulletin

Introduction As the demand for joint replacements continues to rise, optimizing patient outcomes and enhancing recovery have become paramount goals for orthopedic surgeons. Patients used to have minimal mobility following a Total Knee Arthroplasty (TKA) or Total Hip Arthroplasty (THA) due to pain or the effects of sedation from anesthesia. This would lead to longer hospital stays, more complications, and higher opioid use.¹ These surgeries also resulted in levels of blood loss that required transfusion therapy postoperatively.² In recent years, there has been a paradigm shift in postoperative care for total joint arthroplasty (TJA), marked by significant advancements …

A Review Of The Effects Of Early Sport Specialization On The Health Of Adolescent Baseball Players, Robert C. Juniewicz

Bone Bulletin

Introduction

Participation in sports during adolescence is beneficial for participants as it improves fitness, enhances psychosocial development, increases academic performance, and boosts self-esteem.¹ One of the most popular sports among adolescent athletes is baseball, with nearly 500,000 high school players in the United States in 2020.1 While participation in sports has been shown to have clear benefits and has been steadily increasing, recent decades have also seen a dramatic rise in the level of competition.² As a direct result, there has been an increase in the prevalence of early sports specialization (ESS) with an estimated 14-47% of adolescent …

The Ins And Outs Of Wide-Awake Hand Surgery, Molly Milano

Bone Bulletin

Introduction

As the name might imply, “wide awake local anesthesia no tourniquet” (WALANT) is a surgical method to perform hand surgery using only a local anesthetic without the use of a tourniquet or any sedation and general anesthetics. The WALANT technique takes advantage of the vasoconstrictive effects of epinephrine combined with the local anesthetic effects of lidocaine to create a surgical field that does not require a tourniquet or general anesthesia.¹ The main contributor is epinephrine, which decreases bleeding in the surgical field while also lengthening lidocaine’s absorption and effect.² When first introduced to the surgical world, the …

Examining The Role Of Augmented Reality In Total Hip Arthroplasty, Joseph Raphael

Bone Bulletin

Background

In 2023, it was reported that total hip arthroplasty (THA) was the main and effective surgical treatment for advanced hip osteoarthritis, osteonecrosis, and rheumatoid arthritis.¹ As the population ages, the number of annual THA procedures is projected to grow and reach 635,000 by the year 2030.² As such, further improving outcomes in THA will benefit this large population. On average age for individuals who sustain a hip fracture is 80 years old and the lifetime prevalence of hip fractures is 20% in women and 10% in men.³ Fracture reduction and internal fixation or arthroplasty are often …

The Role Of Psychological Readiness In Recovery From Acl Injury In Female Athletes, Samantha Meacock

Bone Bulletin

The Anterior Cruciate Ligament (ACL) injury is common in sports, with female athletes facing a disproportionately higher risk in comparison to male athletes.¹ This susceptibility is the result of a complex relationship between various factors including anatomical, biomechanical, hormonal, neuromuscular, and environmental influences.² In addition, the unique challenges that females face with respect to sports, violence, body image, and family planning create additional stressors that may further contribute to an increased risk for injury.^3,4 Following ACL Reconstruction (ACLR) surgery, these gender discrepancies carry over into recovery as female athletes exhibit decreased rates of return to sport (RTS) …

Shoulder Arthroplasty In Patients With Inflammatory Arthritis: Preoperative And Perioperative Management Of Disease Modifying Anti-Rheumatic Drug Therapy, Daniel Kwak

Bone Bulletin

Introduction

Inflammatory arthritis is a debilitating systemic autoimmune and inflammatory disease that leads to joint damage, resulting in significant pain and disability. Rheumatoid arthritis (RA) is the most common inflammatory arthritis typically associated with advanced arthritic changes of the glenohumeral joint as well as with rotator cuff tears.²⁰ Since the introduction of disease modifying anti-rheumatic drug (DMARD) therapy, patients diagnosed with inflammatory rheumatic diseases have observed improvements in pain management and functional outcomes, alongside a reduction in the occurrence of upper limb arthroplasties.¹⁶ Nonetheless, total joint arthroplasty still remains common in the treatment of RA.^8,14

One recognized …

Revolutionizing Orthopaedics: Exploring The Therapeutic Potential Of Stem Cells, Harrison Fellheimer

Bone Bulletin

The development of stem cells holds the key to a revolutionary era in medicine, unlocking multisystem processes that will help restore normal function in the human body. Stem cells are undifferentiated cells that have the capability to give rise to cells of the same type, and from which new cells can arise through the process of differentiation. Several sources of stem cells can be broadly categorized into three main types: embryonic stem cells (ESC), adult stem cells, and induced pluripotent stem cells (iPSCs).¹

Exploring The Importance Of Implant Selection In Total Hip Arthroplasty, John Czarnecki

Bone Bulletin

Introduction

Total Hip Arthroplasty (THA) is a rapidly growing field within the United States. In 2023 alone, 1,050,821 arthroplasties were performed, making it the second-most performed arthroplasty of the year.1 With over a million of these procedures completed each year, there are several medical device companies that create their own implants to be used in these procedures. Each company can patent their own device and go through a thorough process involving the FDA to receive approval provided there is evidence from clinical trials that demonstrates their device improves patient outcomes.2 With the many implant options available, one question to consider …

A Spotlight On The Various Subspecialties Of Orthopedic Surgery, Ryan Garemani

Bone Bulletin

Introduction

Currently, 60% of orthopedic surgeons are specialists, 25% have specialty interests, and the remaining 15% are generalists.¹ Given the numbers, most orthopedists focus on a specific anatomical area or patient demographic, from delicate nerve work to the larger surgical field encountered in adult reconstruction. This article embarks on a journey through the diverse and impactful world of orthopedic subspecialties, shedding light on the breadth of practice offered.

According to Joseph A. Abboud, MD, a Rothman Orthopedics upper extremity surgeon, residents typically decide on a sub-specialty in their third or fourth year. For medical students, whether captivated by orthopedics …

Exploring Approaches To Treatment Of Musculoskeletal Injuries, Catherine Alvaro

Bone Bulletin

When approaching musculoskeletal injuries, there are many components of the patient assessment that contribute to different treatment options. Interviews with both an orthopedic surgeon and a sports medicine physician revealed similar yet different ways of diagnosing and treating orthopedic conditions.

Foreword, Alan S. Hilibrand

Bone Bulletin

As the Vice Chair of Academic Affairs and Faculty Development and as Director of Undergraduate Medical Education for the Department of Orthopaedic Surgery at the Sidney Kimmel Medical College, I am honored to once again have this opportunity to write a foreword for the second issue of the Bone Bulletin.

For many years, the DePalma Orthopaedic Society has provided medical students at SKMC with an excellent venue to learn about orthopaedic surgery, and its members continue to focus much time and energy on mentoring younger students interested in the field of orthopedic surgery. The DePalma leadership has worked hard …

Editors’ Note, Ari Clements, Amit Syal

Bone Bulletin

This year, we are very excited to announce the second issue of the Bone Bulletin, DePalma Orthopaedic Society’s student-run, non-peer reviewed journal for Sidney Kimmel Medical College (SKMC) students. The journal was initially started to provide another way to become involved with orthopaedics in medical school as well as providing a unique platform to report on diverse aspects of the field through editorial and opinion pieces.

By providing close 1-on-1 mentorship with a Rothman physician, the Bone Bulletin gives students a hands-on opportunity to engage with orthopaedic research and developments. Throughout this journal, you will find a variety of …

Bilateral Eagle Syndrome: A Surprising Cause Of Neck Pain, Kailyn M. Mutsch, Alla Zamulko

Aesculapius Journal (Health Sciences & Medicine)

We report the case of a 45-year-old female who presented with chronic neck pain primarily left sided, globus sensation, and dysphagia for several years. Bilateral elongated styloid processes were identified on CT scan completed prior to the visit. Clinical and radiographic features were consistent with bilateral Eagle syndrome. Eagle syndrome can manifest as a constellation of symptoms characterized by throat and neck pain aggravated by rotation of the head, globus sensation of the throat, dysphagia, headache, tinnitus, syncope, or transient ischemic attacks in some cases. The objective of this case report was to discuss the features of Eagle syndrome and …

Geographic Distribution Of Melanoma Cases In Maine: Identifying Vulnerable Counties For Targeted Intervention, Joshua R. Parbs, Madeline Prentiss, Calla Hladky, Henry Stoddard, Kathryn Stevens, Elizabeth V. Seiverling, Peggy Cyr

Journal of Maine Medical Center

Introduction: Maine has the twelfth highest incidence of melanoma in the United States. The purpose of this study was to determine which Maine counties were the most impacted by melanoma through the use of geographical methods. Identification of counties with the highest prevalence of melanoma will help in targeting future training and public health interventions.

Methods: All melanoma cases (n=5,340) reported to the Maine CDC Cancer Registry from 2013 to 2018 were sorted by pathologic T stage. Data were sorted by county and population-adjusted. Population data and provider data came from Area Health Resource Files. County and zip-code maps were …

The Effectiveness Of Dexmedetomidine As An Adjunct In Spinal Anesthesia For Pain Relief In Cesarean Patients: A Scoping Review, Tyler Polanco Bsn, Rn, William Riley Bsn, Rn, Michelle Russell Bsn, Rn, Christina Samson Bsn, Rn, Bria Sharp Bsn, Rn, Dwayne Accardo Dnp, Ccrna, Faana

Doctor of Nursing Practice Projects

No abstract provided.

Medicinal Treatment Versus Dialysis In End Stage Renal Disease Patients With Perioperative Hyperkalemia: A Scoping Review, Haley Bishop, Bsn, Rn, Hannah White, Bsn, Rn, Matthew Wilhaucks, Bsn, Rn, Ashton Weaver, Bsn, Rn, Christin Simpson, Bsn, Rn, Margaret Harvey, Phd, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

No abstract provided.

Immunophenotypic Predictors Of Influenza Vaccine Immunogenicity In Pediatric Hematopoietic Cell Transplant Recipients., Justin Z. Amarin, Daniel E. Dulek, Joshua Simmons, Haya Hayek, James D. Chappell, Cindy Hager Nochowicz, Carrie L. Kitko, Jennifer E. Schuster, Flor M. Muñoz, Claire E. Bocchini, Elizabeth A. Moulton, Susan E. Coffin, Jason L. Freedman, Monica I. Ardura, Rachel L. Wattier, Gabriela Maron, Michael Grimley, Grant Paulsen, Lara Danziger-Isakov, Paul A. Carpenter, Janet A. Englund, Natasha B. Halasa, Andrew J. Spieker, Spyros A. Kalams

Manuscripts, Articles, Book Chapters and Other Papers

Pediatric hematopoietic cell transplant (HCT) recipients exhibit poor serologic responses to influenza vaccination early after transplant. To facilitate the optimization of influenza vaccination timing, we sought to identify B- and T-cell subpopulations associated with influenza vaccine immunogenicity in this population. We used mass cytometry to phenotype peripheral blood mononuclear cells collected from pediatric HCT recipients enrolled in a multicenter influenza vaccine trial comparing high- and standard-dose formulations over 3 influenza seasons (2016-2019). We fit linear regression models to estimate relationships between immune cell subpopulation numbers before vaccination and prevaccination to postvaccination geometric mean fold rises in antigen-specific (A/H3N2, A/H1N1, and …

Structural Variants Involving Mllt10 Fusion Are Associated With Adverse Outcomes In Pediatric Acute Myeloid Leukemia., Oussama Abla, Rhonda E. Ries, Tim Triche, Robert B. Gerbing, Betsy Hirsch, Susana Raimondi, Todd Cooper, Jason E. Farrar, Nathaniel Buteyn, Lauren M. Harmon, Hong Wen, Aniruddha J. Deshpande, E Anders Kolb, Alan S. Gamis, Richard Aplenc, Todd Alonzo, Soheil Meshinchi

Manuscripts, Articles, Book Chapters and Other Papers

MLLT10 gene rearrangements with KMT2A occur in pediatric acute myeloid leukemia (AML) and confer poor prognosis, but the prognostic impact of MLLT10 in partnership with other genes is unknown. We conducted a retrospective study with 2080 children and young adults with AML registered on the Children's Oncology Group AAML0531 (NCT00372593) and AAML1031 trials (NCT01371981). Transcriptome profiling and/or karyotyping were performed to identify leukemia-associated fusions associated with prognosis. Collectively, 127 patients (6.1%) were identified with MLLT10 fusions: 104 (81.9%) with KMT2A::MLLT10, 13 (10.2%) with PICALM::MLLT10, and 10 (7.9%) X::MLLT10: (2 each of DDX3X and TEC), with 6 partners (DDX3Y, CEP164, SCN2B, …

Spontaneous Spinal Epidural Hematoma Presenting As A Stroke Alert: A Case Report, Christian Flores Do, Monisha Bindra Do, Adam Sigal Md, Michael A. Romeo Do

Tower Health Research Day

No abstract provided.

Evidence-Based Practice Education For Nurses Caring For Oncology Patients With Chemotherapy-Induced Peripheral Neuropathy: A Quality Improvement Project., Natalie N. Ellis, Pamela Hardesty

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Nurses are one of the primary sources of information for patients during their healthcare journey. Patient education can mean the difference between a positive and negative outcome. Oncology patients undergoing chemotherapy are an especially vulnerable population and education and preparation for potential side-effects related to chemotherapy is important. There are several ways to control chemotherapy-induced side effects (CISE). One of the debilitating side effects can be chemotherapy-induced peripheral neuropathy (CIPN). While difficult to manage, the support of nursing staff to encourage patients to take an active role in their care could help decrease the risk of CIPN and improve …

Evidence-Based Practice - Oral Mucositis Prevention In Chemotherapy Patients: A Benchmark Project, Carrie Davenport

MSN Capstone Projects

The purpose of this implementation project is to help decrease the rates of mucosal barrier injuries (MBI’s) and oral mucositis (OM) in patients receiving chemotherapy on the oncology unit. In 2022, it was reported that seven MBI’s occurred on an oncology unit in a large county hospital in an urban area. This secondary infection has the potential to increase morbidity, increase treatment costs, lengthen hospital stays, and can have a devastating impact on quality of life (Correa et al., 2019). There is currently no protocol in place at the proposed location for this intervention that will help reduce this potential …

Reducing Central Line-Associated Bloodstream Infections (Clabsi) With Chlorhexidine-Impregnated Dressings, Sara Garcia

MSN Capstone Projects

Mitigating and eradicating central line-associated bloodstream infections (CLABSI) is a vital patient safety priority. These healthcare-associated infections lead to patient fatalities and incur costly, preventable expenses. Therefore, it is imperative to assess central venous catheter (CVC) maintenance protocols to mitigate the likelihood of infection. Federal guidelines advocate using chlorhexidine (CHG) dressings to lower this risk (Centers for Disease Control and Prevention, 2017). A comprehensive central line maintenance bundle includes incorporating a CHG dressing as a critical measure in reducing the risk of CLABSI (Buetti et al., 2022). Consequently, the escalating infection rates underscore the necessity for implementing CHG dressings (Buetti …

Adding Ofirmev: The Effectiveness Of Multimodal Treatment, Kimberly R. Bilal-Williams

MSN Capstone Projects

This project is on enhancing pain management in total knee arthroplasty (TKA) clients via the intravenous (IV) administration of acetaminophen (Ofirmev) by multimodal regimen. The patient, intervention, comparison, outcome, and time (PICOT) question shaping this initiative looks at frequency and intensity of patients’ pain scores as well as practical outcome measures such as healing and physical therapy during the recovery period ending with discharge. After a thorough literature synopsis, it is evident that multimodal pain management strategies including IV acetaminophen provide a better prospectus in comparison to the ones that solely employ opioids. Research repeatedly demonstrates the use of IV …

Effectiveness Of The Novel Ventilation System In The Ambulance For Airborne Particle Reduction, Dhanadol Rojanasarntikul

Chulalongkorn Medical Journal

Background: During the Coronavirus disease (COVID-19) pandemic, emergency medical service (EMS) workers areexposed to infectious particles in closed spaces such as in the ambulance. Few studies have demonstrated the effectiveness of ambulance ventilation system in reducing airborne particles.

Objective: To assess the effectiveness of an ambulance ventilation system in reducing the volume density of airborne particles and return-to-background time.

Methods: Aerosol particles of various sizes were administered into the cabin via nebulization for one minute. The aerosol volume concentrations of particles at 0.5-1; 1-2.5; and 2.5-5 microns were measured with three different ventilation rates (switched off, medium and maximum) …

Improving Patients’ Perception Of Provider Trust And Communication With Birth Plans, Christelle Reeves, Nicole Tenzel, Timothy Kremer

North Texas Research Forum 2024

Objective: Birth plans are an effective tool for a pregnant person to express their desires and expectations for labor and postpartum. Shortcomings of birth plans can be found whenever there is a lapse in communication between provider and patient. In the management of labor and emergent situations, it has been observed by patients that obstetric providers can communicate in authoritarian and dismissive manners. In response to this, birth plans were developed to serve as a guide in these scenarios. Birth plans allow a pregnant person to design a thoughtful plan of action with their healthcare provider before giving birth, rather …

Therapeutic Use Of Music For Geriatric Dementia Patients, Katelynn Roscioli

Scholar Week 2016 - present

Dementia impacts millions of individuals and their families worldwide, yet many caregivers remain untrained, unpaid, and unable to maintain their own health while caring for their patients. Despite the need for support, limited resources exist to aid these caregivers in combatting this progressive, debilitating disease. One possibility lies in practices rooted in music therapy, which have been shown to restore memory retention, personhood, and quality of life in dementia patients. However, individuals outside of music therapists, especially those with limited musical backgrounds, may not consider implementing music therapy within their care plan. To make this approach more accessible, a website …