Medicine and Health Sciences Commons^™

Understanding Decision Making As It Influences Treatment In Thoracolumbar Burst Fractures Without Neurological Deficit: Conceptual Framework And Methodology, Charlotte Dandurand, Cumhur F. Öner, Olesja Hazenbiller, Richard J. Bransford, Klaus Schnake, Alexander R. Vaccaro, Lorin M. Benneker, Emiliano Vialle, Gregory D. Schroeder, Shanmuganathan Rajasekaran, Mohammad El-Skarkawi, Rishi M. Kanna, Mohamed Aly, Martin Holas, Jose A. Canseco, Sander Muijs, Eugen Cezar Popescu, Jin Wee Tee, Gaston Camino-Willhuber, Andrei Fernandes Joaquim, Ory Keynan, Harvinder Singh Chhabra, Sebastian Bigdon, Ulrich Spiegel, Marcel F. Dvorak

Rothman Institute Faculty Papers

STUDY DESIGN: This paper presents a description of a conceptual framework and methodology that is applicable to the manuscripts that comprise this focus issue.

OBJECTIVES: Our goal is to present a conceptual framework which is relied upon to better understand the processes through which surgeons make therapeutic decisions around how to treat thoracolumbar burst fractures (TL) fractures.

METHODS: We will describe the methodology used in the AO Spine TL A3/4 Study prospective observational study and how the radiographs collected for this study were utilized to study the relationships between various variables that factor into surgeon decision making.

RESULTS: With 22 …

Human Parechovirus Central Nervous System Infection In A Young Infant Cohort, Aspasia Katragkou, Avni Sheth, Christina Gagliardo, Jessica Aquino, Niva Shah, Eberechi Nwaobasi-Iwuh, Christina Melchionne, Paige Black, Stephanie Chiu, Cecilia Di Pentima

Department of Pediatrics Faculty Papers

In 2022, a surge in cases of pediatric human parechovirus (HPeV) central nervous system infections in young infants was seen at our institution. Despite the dramatic increase in the number of cases seen that year, the clinical features of the illness were similar to prior years. The recent pediatric HPeV surge highlights the need to evaluate treatment options and standardize follow-up to better understand the long-term prognosis of infants with HPeV infection.

Evaluating The Efficacy Of Chatgpt In Navigating The Spanish Medical Residency Entrance Examination (Mir): Promising Horizons For Ai In Clinical Medicine., Francisco Guillen-Grima, Sara Guillen-Aguinaga, Laura Guillen-Aguinaga, Rosa Alas-Brun, Luc Onambele, Wilfrido Ortega, Rocio Montejo, Enrique Aguinaga-Ontoso, Paul Barach, Ines Aguinaga-Ontoso

Department of Medicine Faculty Papers

UNLABELLED: The rapid progress in artificial intelligence, machine learning, and natural language processing has led to increasingly sophisticated large language models (LLMs) for use in healthcare. This study assesses the performance of two LLMs, the GPT-3.5 and GPT-4 models, in passing the MIR medical examination for access to medical specialist training in Spain. Our objectives included gauging the model's overall performance, analyzing discrepancies across different medical specialties, discerning between theoretical and practical questions, estimating error proportions, and assessing the hypothetical severity of errors committed by a physician.

MATERIAL AND METHODS: We studied the 2022 Spanish MIR examination results after excluding …

Acute Hepatic Porphyrias: Recommendations For Diagnosis And Management With Real-World Examples, Akshata Moghe, Amy Dickey, Angelika Erwin, Rebecca K. Leaf, Alan O'Brien, John G. Quigley, Manish Thapar, Karl E. Anderson

Division of Gastroenterology and Hepatology Faculty Papers

Acute hepatic porphyria (AHP) is a group of four rare inherited diseases, each resulting from a deficiency in a distinct enzyme in the heme biosynthetic pathway. Characterized by acute neurovisceral symptoms that may mimic other medical and psychiatric conditions, lack of recognition of the disease often leads to a delay in diagnosis and initiation of effective treatment. Biochemical testing for pathway intermediates that accumulate when the disease is active forms the basis for screening and establishing a diagnosis. Subsequent genetic analysis identifies the pathogenic variant, supporting screening of family members and genetic counseling. Management of AHP involves avoidance of known …

Postoperative Discharge Destination Impacts 30-Day Outcomes: A National Surgical Quality Improvement Program Multi-Specialty Surgical Cohort Analysis, Carlos Riveros, Sanjana Ranganathan, Yash Shah, Emily Huang, Jiaqiong Xu, Michael Geng, Zachary Melchiode, Siqi Hu, Brian Miles, Nestor Esnaola, Dharam Kaushik, Angela Jerath, Christopher Wallis, Raj Satkunasivam

Student Papers, Posters & Projects

Surgical patients can be discharged to a variety of facilities which vary widely in intensity of care. Postoperative readmissions have been found to be more strongly associated with post-discharge events than pre-discharge complications, indicating the importance of discharge destination. We sought to evaluate the association between discharge destination and 30-day outcomes. A retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Patients were dichotomized based on discharge destination: home versus non-home. The main outcome of interest was 30-day unplanned readmission. The secondary outcomes included post-discharge pulmonary, infectious, thromboembolic, and bleeding complications, …

Venous Thromboembolism In Orthopedic Surgery: Global Guidelines, Kadir Uzel, İbrahim Azboy, Javad Parvizi

Rothman Institute Faculty Papers

Venous thromboembolism (VTE) is a severe complication that can occur after major orthopedic procedures. As VTE-related morbidity and mortality are a significant concern for both medical professionals and patients, and preventative measures are typically employed. Multiple organizations, including the American College of Chest Physicians (ACCP) and the American Academy of Orthopedic Surgeons (AAOS), have developed guidelines for VTE prophylaxis specifically in patients undergoing joint replacement procedures. However, recently, the International Consensus Meeting (ICM) was convened, which brought together over 600 experts from 68 countries and 135 international societies. These experts, spanning a range of medical disciplines including orthopedic surgery, anesthesia, …

Feasibility And Outcomes Of Supplemental Gait Training By Robotic And Conventional Means In Acute Stroke Rehabilitation, Mukul Talaty, Alberto Esquenazi

Moss-Magee Rehabilitation Papers

INTRODUCTION: Practicality of implementation and dosing of supplemental gait training in an acute stroke inpatient rehabilitation setting are not well studied but can have positive impact on outcomes.

OBJECTIVES: To determine the feasibility of early, intense supplemental gait training in inpatient stroke rehabilitation, compare functional outcomes and the specific mode of delivery.

DESIGN AND SETTING: Assessor blinded, randomized controlled trial in a tertiary Inpatient Rehabilitation Facility.

PARTICIPANTS: Thirty acute post-stroke patients with unilateral hemiparesis (≥ 18 years of age with a lower limb MAS ≤ 3).

INTERVENTION: Lokomat® or conventional gait training (CGT) in addition to standard mandated therapy time. …

Does Physical Therapy Impact Clinical Outcomes After Lumbar Decompression Surgery?, Jeremy C. Heard, Nicholas D. D'Antonio, Mark J. Lambrechts, Payton Boere, Tariq Z. Issa, Yunsoo A. Lee, Jose A. Canseco, Ian David Kaye, Barrett R. Woods, Alan S. Hilibrand, Alexander R. Vaccaro, Christopher K. Kepler, Gregory D. Schroeder

Rothman Institute Faculty Papers

OBJECTIVES: The objectives of our study were to (1) determine if physical therapy (PT) impacts patient-reported outcomes (PROMs) after lumbar decompression surgery and (2) determine if PT impacts postsurgical readmissions or reoperations after lumbar decompression surgery.

METHODS: Patients >18 years of age who underwent primary one‑ or two‑level lumbar decompression at our institution were identified. Patient demographics, surgical characteristics, surgical outcomes (all‑cause 90 days readmissions and 90 days surgical readmissions), and patient‑reported outcomes (PROMs) were compared between the groups. Multivariate linear regression was utilized to determine the individual predictors of 90 days readmissions and PROMs at the 1‑year postoperative point. …

The Role Of Exercise In The Alleviation Of Neuropathic Pain Following Traumatic Spinal Cord Injuries: A Systematic Review And Meta-Analysis, Amirmohammad Toloui, Hamzah Adel Ramawad, Pantea Gharin, Alexander Vaccaro, Hamed Zarei, Mostafa Hosseini, Mahmoud Yousefifard, Vafa Rahimi-Movaghar

Rothman Institute Faculty Papers

OBJECTIVE: The objective of this systematic review and meta-analysis was to assess the efficacy of exercise in neuropathic pain following traumatic spinal cord injuries.

METHODS: The search was conducted in MEDLINE, Embase, Scopus, and Web of Science by the end of 2022. Two independent researchers included the articles based on the inclusion and exclusion criteria. A standardized mean difference was calculated for each data and they were pooled to calculate an overall effect size. To assess the heterogeneity between studies, I2 and chi-square tests were utilized. In the case of heterogeneity, meta-regression was performed to identify the potential source.

RESULTS: …

Editorial: Intervertebral Disc Degeneration And Osteoarthritis: Mechanisms Of Disease And Functional Repair., Graciosa Q Teixeira, Jana Riegger, Raquel M Gonçalves, Makarand V. Risbud

Department of Orthopaedic Surgery Faculty Papers

No abstract provided.

An Educational Case For Applying The Alveolar- Arterial Gradient In Hypoxemia: An Underutilized And Underappreciated Clinical Tool, Chioma Nwonu, Do, Michael Dong, Md, Daniel Kramer, Md

The Medicine Forum

The Alveolar-arterial gradient, commonly known as the A-a gradient, measures the difference in the oxygen concentration in the alveoli and the arteries across the capillary membrane in the lung. In an ideal system, the A-a gradient would be zero because there would be perfect equilibrium as oxygen diffuses and equalizes across the alveolar and arterial sides of the capillary membrane. However, there is a physiologic A-a gradient because of the differences in perfusion and ventilation in the apical and basilar regions of the lungs. Because this relationship exists, the changes in the A-a gradient have clinical utility in guiding the …

The Medicine Forum: Volume 24

The Medicine Forum

The Journal of Thomas Jefferson University Hospital - Department of Internal Medicine, Volume 24, 2022-2023

TABLE OF CONTENTS

• Case Reports
• Ultrasound Education

Secondary Analysis Of A James Lind Alliance Priority Setting Partnership To Facilitate Knowledge Translation In Degenerative Cervical Myelopathy (Dcm): Insights From Ao Spine Recode-Dcm, Benjamin Davies, Jamie Brannigan, Oliver D. Mowforth, Danyal Khan, Angus G.K. Mcnair, Lindsay Tetreault, Iwan Sadler, Ellen Sarewitz, Bizhan Aarabi, Brian Kwon, Toto Gronlund, Vafa Rahimi-Movaghar, Carl Moritz Zipser, Peter John Hutchinson, Shekar Kurpad, James S. Harrop, Jefferson R. Wilson, James D. Guest, Michael G. Fehlings, Mark R.N. Kotter

Department of Neurosurgery Faculty Papers

OBJECTIVES: To explore whether a James Lind Alliance Priority Setting Partnership could provide insights on knowledge translation within the field of degenerative cervical myelopathy (DCM).

DESIGN: Secondary analysis of a James Lind Alliance Priority Setting Partnership process for DCM.

PARTICIPANTS AND SETTING: DCM stake holders, including spinal surgeons, people with myelopathy and other healthcare professionals, were surveyed internationally. Research suggestions submitted by stakeholders but considered answered were identified. Sampling characteristics of respondents were compared with the overall cohort to identify subgroups underserved by current knowledge translation.

RESULTS: The survey was completed by 423 individuals from 68 different countries. A total …

Identification Of Potential Non-Invasive Biomarkers In Diastrophic Dysplasia, Chiara Paganini, Ricki S. Carroll, Chiara Gramegna Tota, Andrea J. Schelhaas, Alessandra Leone, Angela L. Duker, David A. O'Connell, Ryan F. Coghlan, Brian Johnstone, Carlos R. Ferreira, Sabrina Peressini, Riccardo Albertini, Antonella Forlino, Luisa Bonafé, Ana Belinda Campos-Xavier, Andrea Superti-Furga, Andreas Zankl, Antonio Rossi, Michael B. Bober

Student Papers, Posters & Projects

Diastrophic dysplasia (DTD) is a recessive chondrodysplasia caused by pathogenic variants in the SLC26A2 gene encoding for a cell membrane sulfate/chloride antiporter crucial for sulfate uptake and glycosaminoglycan (GAG) sulfation. Research on a DTD animal model has suggested possible pharmacological treatment approaches. In view of future clinical trials, the identification of non-invasive biomarkers is crucial to assess the efficacy of treatments. Urinary GAG composition has been analyzed in several metabolic disorders including mucopolysaccharidoses. Moreover, the N-terminal fragment of collagen X, known as collagen X marker (CXM), is considered a real-time marker of endochondral ossification and growth velocity and was studied …

Treatment Of Adult Spasticity With Botox (Onabotulinumtoxina): Development, Insights, And Impact, Alberto Esquenazi, Wolfgang H. Jost, Catherine C. Turkel, Theodore Wein, Rozalina Dimitrova

Moss-Magee Rehabilitation Papers

Upper and lower limb spasticity (ULS, LLS) often occur following a stroke or in patients with other neurological disorders, leading to difficulties in mobility and daily living and decreased quality of life. Prior to the use of onabotulinumtoxinA, antispastic medications had limited efficacy and often caused sedation. Phenol injections were difficult for physicians to perform, painful, and led to tissue destruction. The success of onabotulinumtoxinA in treating cervical dystonia led to its use in spasticity. However, many challenges characterized the development of onabotulinumtoxinA for adult spasticity. The wide variability in the presentation of spasticity among patients rendered it difficult to …

Efficacy Of Externally Paced Training On Pain In Tendinopathy: A Systematic Review And Meta Analysis, Dylan Carmody, Alyssa Conanan, Daniel Moeller, Sarah Khoblall, Christopher Keating

Department of Physical Therapy Faculty Papers

Tendinopathy is a common condition with treatments focused on local tissue adaptations. Externally paced loading programs are designed to cue (visually, auditorily, or temporally) a person as to when to perform an exercise repetition during a set of repetitions. Externally paced loading programs propose central and peripheral changes with tendinopathy but conclusions regarding their efficacy on pain outcomes remain limited. Our review seeks to explore the efficacy of externally paced loading as a method to reduce self-reported pain in tendinopathic conditions. An electronic database search was conducted of PubMed, SPORTDiscus, Scopus, and CINAHL databases. A total of 2,104 studies were …

Association Of Brain Age, Lesion Volume, And Functional Outcome In Patients With Stroke, Sook-Lei Liew, Nicolas Schweighofer, James H. Cole, Artemis Zavaliangos-Petropulu, Bethany P. Lo, Laura K.M. Han, Tim Hahn, Lianne Schmaal, Miranda R. Donnelly, Jessica N. Jeong, Zhizhuo Wang, Aisha Abdullah, Jun H. Kim, Alexandre Hutton, Giuseppe Barisano, Michael R. Borich, Lara A. Boyd, Amy Brodtmann, Cathrin M. Buetefisch, Winston D. Byblow, Jessica M. Cassidy, Charalambos C. Charalambous, Valentina Ciullo, Adriana Bastos Conforto, Rosalia Dacosta-Aguayo, Julie A. Dicarlo, Martin Domin, Adrienne N. Dula, Natalia Egorova-Brumley, Wuwei Feng, Fatemeh Geranmayeh, Chris M. Gregory, Colleen A. Hanlon, Kathryn Hayward, Jess A. Holguin, Brenton Hordacre, Neda Jahanshad, Steven A. Kautz, Mohamed Salah Khlif, Hosung Kim, Amy Kuceyeski, David J. Lin, Jingchun Liu, Martin Lotze, Bradley J. Macintosh, John L. Margetis, Maria Mataro, Feroze B. Mohamed, Emily R. Olafson, Gilsoon Park, Fabrizio Piras, Kate P. Revill, Pamela Roberts, Andrew D. Robertson, Nerses Sanossian, Heidi M. Schambra, Na Jin Seo, Surjo R. Soekadar, Gianfranco Spalletta, Cathy M. Stinear, Myriam Taga, Wai Kwong Tang, Greg T. Thielman, Daniela Vecchio, Nick S. Ward, Lars T. Westlye, Carolee J. Winstein, George F. Wittenberg, Steven L. Wolf, Kristin A. Wong, Chunshui Yu, Steven C. Cramer, Paul M. Thompson

Department of Neurology Faculty Papers

BACKGROUND AND OBJECTIVES: Functional outcomes after stroke are strongly related to focal injury measures. However, the role of global brain health is less clear. In this study, we examined the impact of brain age, a measure of neurobiological aging derived from whole-brain structural neuroimaging, on poststroke outcomes, with a focus on sensorimotor performance. We hypothesized that more lesion damage would result in older brain age, which would in turn be associated with poorer outcomes. Related, we expected that brain age would mediate the relationship between lesion damage and outcomes. Finally, we hypothesized that structural brain resilience, which we define in …

Art Therapy As A Comprehensive Complementary Treatment For Parkinson’S Disease, Tom Ettinger, Marygrace Berberian, Ikuko Acosta, Alberto Cucca, Andrew Feigin, Danilo Genovese, Travis Pollen, Julianne Reiders, Rohita Kilachand, Clara Gomez, Milton Biagioni, Alessandro Di Rocco, Felice M. Ghilardi, John-Ross Rizzo

Department of Exercise Science Faculty Papers

Introduction: Parkinson’s disease (PD) is the second most prevalent neurodegenerative disease. Complementary and alternative therapies are increasingly utilized to address its complex multisystem symptomatology. Art therapy involves motoric action and visuospatial processing while promoting broad biopsychosocial wellness. The process involves hedonic absorption, which provides an escape from otherwise persistent and cumulative PD symptoms, refreshing internal resources. It involves the expression in nonverbal form of multilayered psychological and somatic phenomena; once these are externalized in a symbolic arts medium, they can be explored, understood, integrated, and reorganized through verbal dialogue, effecting relief and positive change.

Methods: 42 participants with mild to …

Therapies In Stiff-Person Syndrome: Advances And Future Prospects Based On Disease Pathophysiology, Marinos Dalakas

Department of Neurology Faculty Papers

Among the glutamic acid decarboxylase (GAD)-antibody-spectrum disorders, the most common phenotypic subset is the stiff-person syndrome (SPS), caused by impaired GABAergic inhibitory neurotransmission and autoimmunity characterized by very high titers of GAD antibodies and increased GAD-IgG intrathecal synthesis. If not properly treated or untreated because of delayed diagnosis, SPS progresses leading to disability; it is therefore fundamental to apply the best therapeutic schemes from the outset. This article is focused on the rationale of specific therapeutic strategies based on the SPS pathophysiology targeting both the impaired reciprocal GABAergic inhibition to symptomatically improve the main clinical manifestations of stiffness in the …

Lived Experience-Centred Word Clouds May Improve Research Uncertainty Gathering In Priority Setting Partnerships, Oliver D. Mowforth, Lance Burn, Danyal Z. Khan, Xiaoyu Yang, Sybil R.L. Stacpoole, Toto Gronlund, Lindsay Tetreault, Sukhvinder Kalsi-Ryan, Michelle L. Starkey, Iwan Sadler, Ellen Sarewitz, Delphine Houlton, Julia Carter, Paige Howard, Vafa Rahimi-Movaghar, James D. Guest, Bizhan Aarabi, Brian K. Kwon, Shekar N. Kurpad, James Harrop, Jefferson R. Wilson, Robert Grossman, Emma K. Smith, Angus Mcnair, Michael G. Fehlings, Mark R.N. Kotter, Benjamin M. Davies

Department of Neurosurgery Faculty Papers

INTRODUCTION: AO Spine RECODE-DCM was a multi-stakeholder priority setting partnership (PSP) to define the top ten research priorities for degenerative cervical myelopathy (DCM). Priorities were generated and iteratively refined using a series of surveys administered to surgeons, other healthcare professionals (oHCP) and people with DCM (PwDCM). The aim of this work was to utilise word clouds to enable the perspectives of people with the condition to be heard earlier in the PSP process than is traditionally the case. The objective was to evaluate the added value of word clouds in the process of defining research uncertainties in National Institute for …

A Primer For The Student Joining The General Thoracic Surgery Service Tomorrow: Primer 2 Of 7., Colin C. Yost, Rohun Bhagat, David Blitzer, Clauden Louis, Jason Han, Fatima G Wilder, Robert A Meguid

Student Papers, Posters & Projects

This medical student primer discusses general thoracic surgery, which involves treating pathologies involving all structures in the thorax except the heart, thoracic aorta, great vessels, and spine.

Total Hip Arthroplasty In Patients With Neurological Conditions: A Systematic Review, Conor S O'Driscoll, Andrew J Hughes, Martin S Davey, Joseph M Queally, Brendan J O'Daly

Rothman Institute Faculty Papers

Background: As operative techniques and implant design have evolved over time, total hip arthroplasty (THA) is increasingly being carried out for patients with neurological impairment. This patient group places unique surgical challenges to the arthroplasty surgeon, which may include contractures, instability, and altered muscular tone. The purpose of this systematic review is to report the patient outcomes, complications, and implant survival following THA for patients with neurological conditions affecting the hip. Thus, we aim to support orthopaedic surgeon decision-making when considering and planning THA for these patients.

Methods: A systematic review was performed as per Preferred Reporting Items for Systematic …

Ventilation Strategies During Extracorporeal Membrane Oxygenation For Neonatal Respiratory Failure: Current Approaches Among Level Iv Neonatal Icus, John Ibrahim, Burhan Mahmood, Robert Digeronimo, Natalie E Rintoul, Shannon E Hamrick, Rachel Chapman, Sarah Keene, Ruth B Seabrook, Zeenia Billimoria, Rakesh Rao, John Daniel, John Cleary, Kevin Sullivan, Brian Gray, Mark Weems, Daniel R Dirnberger

Department of Pediatrics Faculty Papers

To describe ventilation strategies used during extracorporeal membrane oxygenation (ECMO) for neonatal respiratory failure among level IV neonatal ICUs (NICUs).

Design: Cross-sectional electronic survey.

Setting: Email-based Research Electronic Data Capture survey.

Patients: Neonates undergoing ECMO for respiratory failure at level IV NICUs.

Interventions: A 40-question survey was sent to site sponsors of regional referral neonatal ECMO centers participating in the Children's Hospitals Neonatal Consortium. Reminder emails were sent at 2- and 4-week intervals.

Measurements and main results: Twenty ECMO centers responded to the survey. Most primarily use venoarterial ECMO (65%); this percentage is higher (90%) for congenital diaphragmatic hernia. Sixty-five …

Efficacy Of Early Inpatient Rehabilitation Of Post-Covid-19 Survivors: Single-Center Retrospective Analysis, Ning Cao, Jaclyn Barcikowski, Franklin Womble, Bianca Martinez, Yevgeniya Sergeyenko, Jacob H. Koffer, Michael Kwasniewski, Thomas Watanabe, Rui Xiao, Alberto Esquenazi

Moss-Magee Rehabilitation Papers

OBJECTIVE: The aim of this study was to understand the demographic, clinical characteristics, and effectiveness of early inpatient rehabilitation of post-COVID survivors.

DESIGN: A single-center retrospective chart review analysis of 100 patients admitted to a newly created acute COVID rehabilitation unit (CORE+) from April to December 2020 was conducted.

RESULTS: The demographic and clinical characteristics and complications of 100 post-COVID patients were reviewed. Functional outcomes of GG Self-care and Mobility Activities Items (Section GG0130 and GG0170) of the Centers for Medicare & Medicaid Services of the Inpatient Rehabilitation Facility Patient Assessment Instrument (Version 3.0) at admission and discharge, prevalence of …

Sickle Cell Disease Chronic Joint Pain: Clinical Assessment Based On Maladaptive Central Nervous System Plasticity, Tiago Da Silva Lopes, Samir K. Ballas, Jamille Evelyn Rodrigues Souza Santana, Pedro De Melo-Carneiro, Lilian Becerra De Oliveira, Katia Nunes Sá, Larissa Conceição Dias Lopes, Wellington Dos Santos Silva, Rita Lucena, Abrahão Fontes Baptista

Department of Medicine Faculty Papers

Chronic joint pain (CJP) is among the significant musculoskeletal comorbidities in sickle cell disease (SCD) individuals. However, many healthcare professionals have difficulties in understanding and evaluating it. In addition, most musculoskeletal evaluation procedures do not consider central nervous system (CNS) plasticity associated with CJP, which is frequently maladaptive. This review study highlights the potential mechanisms of CNS maladaptive plasticity related to CJP in SCD and proposes reliable instruments and methods for musculoskeletal assessment adapted to those patients. A review was carried out in the PubMed and SciELO databases, searching for information that could help in the understanding of the mechanisms …

Gibbon Surgical Review, Volume 5, Issue 1, 2022

Gibbon Surgical Review

In this Issue:

6 - A History of ECMO and its Use During the COVID-19 Pandemic

8 - The First Pig-to-Human Heart Xenotransplantation

9 - Residency Interviewing in the Zoom Era

10 - An Interview with Dr. Andrew Newman

12 - Lung Transplantation for Patients with Severe COVID-19 Pulmonary Disease

14 - Risk Factors for Five-year Mortality after Carotid Endarterectomy

18 - An Interview with Dr. Scott Cowan

18 - General Surgery 101: The J-Pouch

20 - The Business of Surgery: Recognizing Barriers to Gender Equity

Survey Of Confidence And Knowledge To Manage Patellofemoral Pain In Readers Versus Nonreaders Of The Physical Therapy Clinical Practice Guideline, Richard W. Willy, Lisa T. Hoglund, Neal R. Glaviano, Lori A. Bolgla, David M. Bazett-Jones

Department of Physical Therapy Faculty Papers

Objectives: To compare beliefs of physical therapists (PTs) who read the clinical practice guideline (CPG) for the management of individuals with patellofemoral pain (PFP) to those who have not read the CPG.

Design: Cross-sectional study.

Setting: Online survey.

Participants: 494 currently licensed/registered PTs or physiotherapists.

Main Outcome Measures: Respondents answered Likert-based or open-ended questions regarding the diagnosis, prognosis, risk factors, and management of individuals with PFP, as well as confidence for managing individuals with PFP, especially the ability to identify beneficial and non-beneficial interventions. We dichotomized responses into participants who read (READERS) and did not read (NonREADERS) the CPG.

Results: …

68-Year Old Man With Progressive Weakness And Ventilator Dependent Respiratory Failure: A Case Report Of Sporadic Late Onset Nemaline Myopathy, P. Kirupaharan, Daniel Kramer, Alan Gandler, Lawrence C. Kenyon, Ross Summer

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Background: Neuromuscular pathologies must be considered when caring for patients with persistent or progressive respiratory failure. Pertinent disease states may involve skeletal muscles of respiration or associated neurologic structures including motor neurons, peripheral neurons and the neuromuscular junction. Diagnosis may require pulmonary function testing, neurophysiologic studies, imaging, and/or muscle biopsy.

Case presentation: A 68-year-old male was transferred to our intensive care unit (ICU) for management of ventilator dependent respiratory failure. Upon further historical review, he described gradually worsening gait instability and muscle weakness, which was previously attributed to vascular Parkinsonism in the setting of known cerebrovascular disease. Upon arrival to …

Treatment Of Nonsurgical Refractory Back Pain With High-Frequency Spinal Cord Stimulation At 10 Khz: 12-Month Results Of A Pragmatic, Multicenter, Randomized Controlled Trial., Leonardo Kapural, Jessica Jameson, Curtis Johnson, Daniel Kloster, Aaron Calodney, Peter Kosek, Julie Pilitsis, Markus Bendel, Erika Petersen, Chengyuan Wu, Taissa Cherry, Shivanand P Lad, Cong Yu, Dawood Sayed, Johnathan Goree, Mark K Lyons, Andrew Sack, Diana Bruce, Frances Rubenstein, Rose Province-Azalde, David Caraway, Naresh P Patel

Department of Neurosurgery Faculty Papers

Objective: Spinal cord stimulation (SCS) at 10 kHz (10-kHz SCS) is a safe and effective therapy for treatment of chronic low-back pain. However, it is unclear from existing evidence whether these findings can be generalized to patients with chronic back pain that is refractory to conventional medical management (CMM) and who have no history of spine surgery and are not acceptable candidates for spine surgery. The authors have termed this condition "nonsurgical refractory back pain" (NSRBP) and conducted a multicenter, randomized controlled trial to compare CMM with and without 10-kHz SCS in this population.

Methods: Patients with NSRBP, as defined …

Developing Peri-Operative Rehabilitation In Degenerative Cervical Myelopathy [Ao Spine Recode-Dcm Research Priority Number 6]: An Unexplored Opportunity?, Timothy F Boerger, Allison S Hyngstrom, Julio C Furlan, Sukhvinder Kalsi-Ryan, Armin Curt, Brian K Kwon, Shekar N Kurpad, Michael G Fehlings, James Harrop, Bizhan Aarabi, Vafa Rahimi-Movaghar, James D Guest, Jefferson R Wilson, Benjamin M Davies, Mark R N Kotter, Paul A Koljonen

Department of Neurosurgery Faculty Papers

Study design: Narrative review.

Objective: Degenerative cervical myelopathy is one of the most frequent impairments of the spinal cord encountered internationally in adults. Currently, surgical decompression is the recommended treatment for people with DCM (PwCM) presenting with moderate to severe symptoms or neurological deficits. However, despite surgical intervention, not all patients make a complete recovery due to the irreversible tissue damage within the spinal cord. The objective of this review is to describe the state and gaps in the current literature on rehabilitation for PwCM and possible innovative rehabilitation strategies.

Methods: Literature search.

Results: In other neurological disorders such as …