Medicine and Health Sciences Commons^™

Effects Of Ohio Opioid Prescribing Policy On Postsurgical Prescriptions Following Sports Procedures, Joseph D. Henningsen, Scott Huff, Andrew D. Schneider, Fady Y. Hijji, Andrew W. Froehle, Anil Krishnamurthy

Orthopaedic Surgery Faculty Publications

Background: Prescribed opioid medication after orthopedic sports surgery has been shown to exceed patient requirements. In 2017, as a response to the opioid epidemic, Ohio passed Opioid Prescribing Guidelines (OPG) limiting narcotic prescriptions for acute pain. This study sought to evaluate the effects of the OPG on prescribing behavior of orthopedists following knee arthroscopy (KA), shoulder arthroscopy (SA), and anterior cruciate ligament reconstruction (ACLR).

Methods: An institutional database was queried to calculate morphine equivalent dose (MED) prescribed at discharge, acute follow-up (<90 days), and chronic follow-up (>90 days) and compare MED pre- and post-OPG. Cases were identified over a 2-year period starting 1 year …

Surgical Stabilization Versus Nonoperative Treatment For Flail And Non-Flail Rib Fracture Patterns In Patients With Traumatic Brain Injury, Jonne T.H. Prins, Esther M. M. Van Lieshout, Francis Ali-Osman, Zachary M. Bauman, Eva-Corina Caragounis, Jeff Choi, D. Benjamin Christie Iii, Peter A. Cole, William B. Devoe, Andrew R. Doben, Evert A. Eriksson, Joseph D. Forrester, Douglas R. Fraser, Brendan Gontarz, Claire Hardman, Daniel G. Hyatt, Adam J. Kaye, Huan-Jang Ko, Kiara N. Leasia, Stuart Leon, Silvana F. Marasco, Allison G. Mcnickle, Timothy Nowack, Temi D. Ogunleye, Prakash Priya, Aaron P. Richman, Victoria Schlanser, Gregory Semon, Ying-Hao Su, Michael H. J. Verhofstad, Julie Whitis, Fredric M. Pieracci, Mathieu M. E. Wijffels

Department of Surgery Faculty Publications

Purpose: Literature on outcomes after SSRF, stratified for rib fracture pattern is scarce in patients with moderate to severe traumatic brain injury (TBI; Glasgow Coma Scale ≤ 12). We hypothesized that SSRF is associated with improved outcomes as compared to nonoperative management without hampering neurological recovery in these patients.

Methods: A post hoc subgroup analysis of the multicenter, retrospective CWIS-TBI study was performed in patients with TBI and stratified by having sustained a non-flail fracture pattern or flail chest between January 1, 2012 and July 31, 2019. The primary outcome was mechanical ventilation-free days and secondary outcomes …

Vital Signs, Summer 2022, Boonshoft School Of Medicine

Vital Signs

A seventeen page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, alumni profiles, class notes, and more.

Optimal Dosing Of Enoxaparin In Overweight And Obese Children, Abdallah Derbalah, Stephen Duffull, Catherine M. Sherwin, Kathleen Job, Hesham Al‐Sallami

Pediatrics Faculty Publications

Aim:Current enoxaparin dosing guidelines in children are based on total bodyweight. This is potentially inappropriate in obese children as it may overestimate thedrug clearance. Current evidence suggests that obese children may require lower ini-tial doses of enoxaparin, therefore the aim of this work was to characterise the phar-macokinetics of enoxaparin in obese children and to propose a more appropriatedosing regimen.Methods:Data from 196 unique encounters of 160 children who received enoxa-parin treatment doses were analysed. Enoxaparin concentration was quantified usingthe chromogenic anti factor Xa (anti-Xa) assay. Patients provided a total of 552 anti-Xa samples. Existing published pharmacokinetic (PK) models were fitted …

Hypothesis: Hypermobile Ehlers Danlos Syndrome Is A Determinant Of Fetal And Young Infant Bone Strength, Marvin E. Miller

Pediatrics Faculty Publications

Several studies have demonstrated that young infants who present with unexplained fractures have a higher frequency of joint hypermobility, either in themselves or their parents, compared to the general population. The joint hypermobility is often associated with the autosomal dominant hypermobile form of Ehlers Danlos Syndrome (h-EDS) in which the mother is far more likely the affected parent. Most of these infants have metabolic bone disease as their radiographs often show poor bone mineralization. Some have alleged these infants were abused, while others have stated infants who have h-EDS or a parent with h-EDS are at increased risk to fracture …

Oral Drug Dosing Following Bariatric Surgery: General Concepts And Specific Dosing Advice, Jurjen S. Kingma, Desirée M. T. Burgers, Valerie M. Monpellier, Marinus J. Wiezer, Heleen J. Blussé Van Oud‐Alblas, Janelle D. Vaughns, Catherine M. T. Sherwin, Catherijne A. J. Knibbe

Pediatrics Faculty Publications

Bariatric or weight-loss surgery is a popular option for weight reduction. Depending on the surgical procedure, gastric changes like decreased transit time and volume and increased pH, decreased absorption surface in the small intestine, decreased exposure to bile acids and enterohepatic circulation, and decreased gastrointestinal transit time may be expected. In the years after bariatric surgery, patients will also substantially lose weight. As a result of these changes, the absorption, distribution, metabolism and/or elimination of drugs may be altered. The purpose of this article is to report the general influence of bariatric surgery on oral drug absorption, and to provide …

First Annual Research Symposium Program With Abstracts, Office Of Research Affairs, Boonshoft School Of Medicine

Boonshoft School of Medicine Research Symposium

The program booklet is a compilation of abstracts from oral and poster presentations at Wright State University's First Annual Boonshoft School of Medicine Medical Research Symposium held on April 6, 2022.

Metabolic Bone Disease Of Infancy In The Offspring Of Mothers With Bariatric Surgery: A Series Of 5 Infants In Contested Cases Of Child Abuse, Marvin E. Miller, David Ayoub

Pediatrics Faculty Publications

Background and aims: Metabolic Bone Disease of Infancy is a multifactorial disorder of bone fragility in infants who typically present under 6 months of age with multiple unexplained fractures. Major risk factors for this disorder relate to the fetal time period and include decreased provision of the essential nutrients for bone formation during pregnancy (calcium, phosphate, vitamin D, and protein), prema- turity, and decreased fetal bone loading. Methods: This study presents 5 infants with multiple unexplained fractures born to women who had prior bariatric surgery in which child abuse was alleged, and the alleged perpetrator denied wrong doing. Results: The …

Toward An Ontology Of Collaborative Learning Healthcaresystems, Alexandra H. Vinson, Michael Seid, Breck Gamel, Shehzad Ahmed Saeed, Brandy Fureman, Susan C. Cronin, Katherine Bates, David Hartley

Pediatrics Faculty Publications

Objective:To establish a basis for a domain ontology - a formal, explicit specificationof a shared conceptualization - of collaborative learning healthcare systems (CLHSs)in order to facilitate measurement, explanation, and improvement.Methods:We adapted the“Methontology”approach to begin building an ontologyof CLHSs. We specified the purpose of an ontology, acquired domain knowledge vialiterature review, conceptualized a common framework of CLHSs using a groundedapproach, refined these concepts based on expert panel input, and illustrated con-cept application via four cases.Results:The set of concepts identified as important to include in an ontologyincludes goals, values, structure, actors, environment, and products. To establish thisset of concepts, we gathered input …

Novel Repair Of Costal Margin Rupture With Preoperative 3d Planning, Casey T. Walk, Gregory Semon

Department of Surgery Faculty Publications

WHAT WOULD YOU DO? This is a 32-year-old man involved in a motor vehicle crash in 2019 with chronic left-sided rib pain since. He was initially treated with physical therapy and medical management with no improvement. CT imaging in 2021 noted displaced left lateral seventh and eighth ribs, noted chest wall deformity, and when three-dimensional (3D) reconstruction of his ribs was created, this noted a left- sided costal margin rupture at the sixth and seventh ribs.

Patient-Centered Focus Groups As A Catalyst For Anti-Racism Research And Quality Improvement In An Urban Academic Ob/Gyn Clinic, Samantha Brenner, Fiona Hodges, Tonia J. Rhone, Toni Tipton, Keith Reisinger-Kindle

Obstetrics and Gynecology Faculty Publications

Background •There is a known, pervasive existence of racism within OBGYN with resultant inequities and disparities in patient outcomes •Limited published perspectives of patients with racism in inpatient and outpatient OBGYN •The importance of centering patients’ voices in anti-racism research initiatives is clear •The objective of this study was to utilize patient-centered focus groups to prioritize anti-racism quality improvement and research investigations in the inpatient and outpatient setting