Medicine and Health Sciences Commons^™

Predictors Of Successful Conservative Lung Surgery In Endobronchial Tumors, Ahmed Mohamed Abdelfattah Ahmed Omar, Amr Abdellateef Hassan, Sameh Ibrahim Elsayed

Mansoura Medical Journal

Background: Endobronchial tumors, though rare, often present centrally and may cause airway obstruction. Historically managed by pneumonectomy, conservative lung surgery has emerged as a viable alternative with reduced morbidity. Methods: This retrospective study included 69 adult patients with endobronchial tumors treated surgically at Mansoura University between 2005 and 2024. Patients were divided into two groups: Group 1 underwent pneumonectomy; Group 2 non-pneumonectomy. Clinical, radiological and bronchoscopic data were analyzed to identify predictors of successful conservative surgery. Results: Tumor location, proximity to the carina, preserved distal lung tissue, and higher preoperative FEV1% were significantly associated with conservative surgical success. Therapeutic bronchoscopy …

Government And Insurance And Access (Cgia) Update, James Budd Mpp

The Journal of the Michigan Dental Association

The MDA Board of Trustees has established its 2026 legislative priorities, focusing on dental loss ratios, assignment of benefits, and virtual credit card payment reform. Key issues include addressing the workforce shortage, student debt, and improving Medicaid anesthesia reimbursement. The update also tracks several House Bills, such as those regarding voluntary license surrender (HB 4929) and foreign-trained dentist licensure (HB 4921), which the MDA opposes to maintain standards. Despite a slow legislative session in 2025, the MDA continues to advocate for transparency in third-party litigation and updates to specialty advertising rules. These efforts aim to protect the profession and ensure …

Fitness To Work Evaluation In A Combined Physical And Office Working Activity With Piriformis Syndrome: A Case Report, Arif Prasetya, Nuri Purwito Adi

Occupational and Environmental Medicine Journal of Indonesia

Background Piriformis syndrome (PS) is a neuromuscular disorder with significant impact on workforce productivity. This case report presents a comprehensive evaluation of fitness for work and job modification strategies for a patient with PS in a combined physical and sedentary working environment. A 44-year-old male medical facility supervisor presented with left buttock pain, radiating to the left leg, diagnosed with left gluteal piriformis syndrome. Despite undergoing multiple conservative therapies by Physical Medicine and Rehabilitation Specialist, the patient showed minimal improvement.

Methods A seven-step fitness for work assessment approach was implemented following Indonesian Association of Occupational Medicine Specialists guidelines. The evaluation …

Factors Associated With The Atherogenic Index Of Plasma Among Workers At A National Respiratory Hospital In Jakarta, Muhammad Abror Rizani Fahmi, Herqutanto Herqutanto, Iqbal Mochtar, Dewi Yunia Fitriani, Marsen Isbayuputra, Resultanti Resultanti, Ariningsih Ariningsih

Occupational and Environmental Medicine Journal of Indonesia

Background Cardiovascular diseases (CVD) represent the primary cause of mortality globally. The atherogenic index of plasma (AIP) can predict the risk of CVD more accurately than other indices. Hospital workers are at risk of developing CVD. There are several factors that can influence the AIP. No studies have specifically investigated these associations in Indonesia, particularly regarding the AIP in hospital workers. This study aims to determine factors associated with the AIP among workers at a national respiratory hospital in Jakarta.

Methods This cross-sectional study collects data from the medical check-up records of workers at Persahabatan Hospital in 2024, who met …

Is Being A Shareholder ‘In Name Only’ A Problem?, Daniel Schulte Jd

The Journal of the Michigan Dental Association

This column addresses the legal risks for Michigan dentists entering "shareholder in name only" agreements with non-dentist entities. Michigan law requires dental practices to be owned by licensed dentists to ensure professional control over public healthcare. Arrangements where management companies or manufacturers can reclaim stock for a nominal fee effectively strip the dentist of true ownership. This lack of control can lead to ethical conflicts, such as pressure to sell specific appliances regardless of professional judgment. Engaging in such schemes may endanger a dentist's license by thwarting state laws intended to protect clinical independence.

Does The Mda Still Offer A Staff Compensation Study?, Rachel Sinacola Dds, Ms, Angie Kanazeh

The Journal of the Michigan Dental Association

This Q&A section clarifies that the MDA no longer distributes staff compensation surveys due to 2023 FTC enforcement policy changes. However, members can access UCR fee analysis reports at a discount through PPO Negotiation Solutions. For dentists nearing retirement, the MDA offers retired and retired life membership categories, which provide dues discounts or exemptions for those no longer earning income from dentistry. The source also recommends Best Card for credit card processing to save an average of $6,496 annually. Finally, practitioners are reminded that licensure renewal must be completed through the MiPLUS platform, which primarily issues electronic licenses.

Chatbot Therapy - Help Or Hindrance, Kadi Rae Smith

Anthós

Introduction

Generative artificial intelligence (Gen-AI) chatbots are complex computer programs designed to mimic human conversations using programming that incorporates large language models (LLM) and natural language models (NLM) to simulate human interactions that are being rapidly integrated into everyday life across an increasing amount of online platforms. This article explores the applications and efficacy of chatbots for mental healthcare, from self-directed chatbot interactions to clinician-supervised implementation of chatbot-based therapeutic tools, weighing the benefits and limitations of this ever-expanding technology.

Methodology/Taxonomy

A literature review was conducted primarily using Web of Science, accessed through Portland State University, and Google Scholar, with specifications …

The Correlation Between 25(Oh)D, Blood Lead Levels, And Delta-Aminolevulinic Acid Dehydratase Activity Among Indonesia Male Workers, Ratih Fadhillah, Muhammad Ilyas, Liem Jen Fuk, Levina Chandra Khoe, Muchtaruddin Mansyur

Occupational and Environmental Medicine Journal of Indonesia

Background Lead exposure disrupts the heme synthesis pathway by modifying the activity of Delta-Aminolevulinic Acid Dehydratase (ALAD), contributing to oxidative stress. Vitamin D has been suggested as an antioxidant to influence oxidative balance, but evidence regarding its association with ALAD activity in lead-exposed populations remains limited. This study aimed to analyze the associations between blood lead levels (BLL), serum 25-hydroxyvitamin D [25(OH)D], ALAD activity, and the 25(OH)D/BLL ratio among Indonesian male workers.

Methods A cross-sectional study was conducted among 90 male workers exposed to lead as part of either their occupation or living environment in Java, Indonesia. Serum 25(OH)D, BLL …

Return To Work After Percutaneous Coronary Intervention In Employee With Metabolic Comorbidities: An Evidence-Based Case Report, Bramantyo Eko Wahyudi Mr, Levina Khoe

Occupational and Environmental Medicine Journal of Indonesia

Background This evidence-based case report examines whether metabolic comorbidities independently predict return to work (RTW) after percutaneous coronary intervention (PCI) for myocardial infarction. A 52-year-old male senior manager with type 2 diabetes, hypertension, dyslipidaemia, and central obesity underwent PCI and required structured occupational assessment.

Methods A systematic literature search identified five eligible studies—one national registry cohort, three prospective cohort studies, and one narrative systematic review—critically appraised using Oxford Centre for Evidence-Based Medicine criteria.

Results Metabolic comorbidities showed consistent directional associations with reduced RTW probability in bivariate analyses and independently predicted longterm labour-market exit. However, in multivariate models across three of …

J Mich Dent Assoc January 2026

The Journal of the Michigan Dental Association

Each month, the Journal of the Michigan Dental Association delivers news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. It remains the main publication reaching Michigan dentists and is available worldwide through ADA Commons. The January 2026 (Volume 108, No. 1) issue of the Journal is published in a print format to provide updates and insights for Michigan's oral health community and MDA members. Print editions occur every other month beginning with January.

This issue includes feature articles on Pediatric Dentistry and 2025 Life Membership recipients.

Regular monthly contributions include:

• Editorial …

Life Membership Status Awarded To 61 Members, Mda Membership Department Staff

The Journal of the Michigan Dental Association

The Michigan Dental Association (MDA) recently awarded life membership to 61 members for their long-term commitment, requiring either 30 consecutive or 40 total years of membership. This status includes active life members, who still practice, and retired life members, who are exempt from dues. These individuals contribute to the profession through mentoring, teaching, and legislative outreach, as well as volunteering in local clinics. The article lists new life members across various Michigan districts, including Central, Detroit, and West Michigan. This recognition honors their decades of dedication to organized dentistry and their ongoing impact on both the association and their local …

Lessons Learned From My First Patient Transition, Amrita Patel Dds

The Journal of the Michigan Dental Association

A new associate reflects on the challenges and lessons of transitioning into her father's established practice. The author emphasizes the importance of listening to long-term patients to understand their history and build trust. While new practitioners often feel the need to prove technical skills, patients primarily seek reassurance and continuity of care. Successful transitions require a balance between respecting existing systems and gradually introducing a new perspective. Introductions by the senior doctor can significantly ease patient apprehension. Ultimately, the experience underscores that dentistry is deeply rooted in relationships and communication, requiring patience and humility to maintain the stability of the …

What About Our Teen-Age Patients?, Michelle C. Dziurgot

The Journal of the Michigan Dental Association

This editorial advocates for "mentally treating" teenage patients, specifically those around 14 years of age, as adults. By respecting their concerns and allowing age-appropriate decisions, clinicians can enhance a teen's dental IQ and self-esteem. This approach fosters confidence, communication, and independence, encouraging patients to take accountability for their treatment outcomes. Respectful dialogue leads to better compliance with home care, such as using rotary brushes or wearing retainers. Ultimately, treating teenagers with empathy and valuing their opinions helps them blossom into responsible adults while building lasting professional bonds.

When Should I Pay For Continuing Education?, Jodi Schafer Sphr, Shrm-Scp

The Journal of the Michigan Dental Association

This article outlines legal requirements for compensating staff for Continuing Education (CE) under the Fair Labor Standards Act. Training time is considered "hours worked" unless it is voluntary, outside regular hours, non-job-related, and involves no productive work. If these criteria are not met, employers must pay for training and associated travel time, including it in overtime calculations. While mileage reimbursement is not federally mandated, many practices offer it as a benefit. Creative cost-saving measures include stipends or in-office lunch-and-learns. Establishing a clear, written policy in the employee handbook is essential for consistent application and can serve as a valuable tool …

Turning Your Membership Into Measurable Value, Reva Darling

The Journal of the Michigan Dental Association

MDA membership offers significant financial leverage by negotiating programs that return money to dental practices. In 2025, practices utilizing endorsed vendors realized potential annual savings exceeding $50,000. Highlighted services include MEDVA, which provides virtual assistants to reduce salary expenses by over 60%, and PPO Negotiation Solutions, which has increased some practices' collections significantly. Members also benefit from discounts on dental supplies (TDSC.com), accounting services, and precious metal refining. Furthermore, Bridge Commercial Realty assists with real estate transitions, offering fee discounts and free appraisals. Collectively, these endorsed programs are designed to offset membership dues and strengthen a practice's financial health.

Molar-Incisor Hypomineralization: Diagnosis, Management, And Treatment, Giovana Anovazzi Medeiros Dds, Msc, Phd, Bahareh Enghiad Dmd, James R. Boynton Dds, Ms

The Journal of the Michigan Dental Association

Molar Incisor Hypomineralization (MIH) is a qualitative developmental enamel defect affecting at least one permanent first molar. Characterized by high porosity and reduced mineral content, MIH leads to hypersensitivity, post-eruptive breakdown, and increased caries susceptibility. The etiology is multifactorial, typically occurring between birth and four years of age. Management depends on severity, ranging from topical fluorides and sealants for mild cases to stainless-steel crowns or extractions for severe instances. Because porous enamel facilitates bacterial penetration and pulpal inflammation, achieving effective local anesthesia is often difficult, necessitating individualized behavioral management and early intervention to preserve tooth structure.

Pediatric Dentists’ Best Practices When Treating Children With Autism Spectrum Disorders: A National Survey, Samita Gumber Bds, Mds, James R. Boynton Dds, Ms, Larry B. Salzmann Dds, Rodney J. Vergotine Bchd, Msc(Dent), Faapd, Fiadt, Fabpd, Ficd, Marita R. Inglehart Dipl. Psych., Dr. Phil., Dr. Phil. Habil

The Journal of the Michigan Dental Association

This national survey evaluates how pediatric dentists manage patients with Autism Spectrum Disorder (ASD). While most practitioners collect data on oral hygiene and verbal communication, fewer assess social interaction or sensitivity-related characteristics. The study suggests using supplemental intake forms to plan appointments based on individual needs and functioning levels. Key accommodations reported include behavior guidance, modified appointment times, and operatory adjustments. Results indicate that increased professional experience with ASD correlates with more comprehensive data collection and a higher perceived value of that information. Ultimately, partnering with parents is vital for creating successful dental encounters for children with ASD.

A Systematic Review On Niosomes: Composition, Preparation, And Applications, Sanket Gawade Mr., Sunil Attimarad, Vishakha Desai Ms.

Manipal Journal of Medical Sciences

Conventional drug carrier systems are restricted owing to poor bioavailability, weak stability and non-specific localization, which causes systemic toxicities and reduced therapeutic efficacy. Niosomes, one of the nonionic surfactant vesicular systems, have been suggested that value to overcome these constraints. In this review, we give an account of recent progress in niosome research, highlighting their merits, composition, characterization, and applications.

Niosomes offer several advantages including increased drug bioavailability, targeted delivery and reduced toxicity. Bilayered niosomes can entrap both hydrophilic and lipophilic drugs, therefore allowing simultaneous delivery of actives components. We provide an overview of various techniques for niosome preparation including …

The Evolving Jacd, Toni Roucka

Journal of the American College of Dentists

The Editorial is a feature in each issue of the JACD. It includes commentary on issue content, relevant topics, or other items of interest to the fellowship.

Unpacking And Re-Imagining Dental Ethics With Anti-Oppressive And Interdisciplinary Praxis, Eleanor Fleming Phd, Dds, Mph, Ficd, Facd

Journal of the American College of Dentists

Dental ethics are assumed to be neutral in their intent. With a social contract grounded in liberalism and assumptions centering whiteness, the resulting ethics reinforce hierarchy, otherness, and inequities. Because concepts and practices are rarely neutral, dental ethics is embedded with biases, which results in it falling short of the demands of the 21st century and exacerbating health inequities rather than supporting efforts for health justice. This manuscript invites the reader to reflect critically and re-imagine dental ethics using anti-oppressive and interdisciplinary praxis. For the improvement of public health, the narrowing of inequities, and a functioning oral health system, the …

Dr. William Thomas Green Morton, Civil War Hero, Peter H. Jacobsohn Dds, Facd

Journal of the American College of Dentists

This article examines the overlooked Civil War contributions of Dr. William Thomas Green Morton, the dentist best known as the Father of Surgical Anesthesia. While Morton’s role in introducing ether anesthesia to surgery is well documented, his service as a volunteer anesthetist for the Union Army remains largely unrecognized in Civil War literature. Drawing on contemporary accounts, letters, and eyewitness descriptions, the article highlights Morton’s presence on major battlefields, where he administered ether to thousands of wounded soldiers. His work dramatically reduced surgical pain, improved morale, and marked the earliest example of organized military anesthesia in American history.

Moving Forward With Purpose: Aadej Adopts New Mission, Vision, And Values Statements, Jasmine Shafagh Dmd

AADEJ - The Communicator

Regular feature from the president of AADEJ, Dr. Jasmine R. Shafagh with the latest updates from AADEJ.

Distal Adding-On As A Complication Of Posterior Spinal Fusion In Adolescent Idiopathic Scoliosis: A Scoping Review Of Contemporary Evidence, Hussein Hashem, Hassan Abou Adma, Joseph Hayek, Ali Rezazadeh Shirazi, Karim Gaber, Waleed Kishta

Western Journal of Orthopaedics

Distal adding-on (DAO) is a complication of spinal fusion characterized by postoperative deformity progression distal to the fusion construct. DAO after posterior spinal fusion for adolescent idiopathic scoliosis (AIS) is variably defined and inconsistently managed. This scoping review synthesizes evidence on DAO detection, management, and outcomes. A PRISMA-ScR–guided search identified relevant studies. Thirty-one studies (2,998 patients; median follow-up, 30 months) met inclusion criteria. Reported DAO incidence ranged from 3.5% to 62.5%, reflecting heterogeneity in definitions, patient factors, surgical constructs, and follow-up duration. Revision surgery was infrequent and typically delayed. When performed, it was most often prompted by progressive coronal decompensation …

Infection Rates In Gunshot-Related Hand Fractures Treated Nonoperatively, T. Kyle Summers, Ian Garrison, Matthew C. Watterson, Brandon Barnes, Charles Rodriguez-Feo

Western Journal of Orthopaedics

Background: Firearm-associated injuries in the U.S. represent a major public health crisis, contributing substantially to major levels of morbidity, mortality, and economic stress. Recommendations for the management of gunshot-related hand fractures remain limited, particularly in low-velocity injuries, and current guidance often leaves treatment decisions to the discretion of the operating surgeon. Methods: A retrospective analysis was performed to identify phalangeal and metacarpal fractures at a Level I trauma center from 2017 to 2023, resulting in 579 patients. Only fractures resulting from firearm injuries were included, resulting in 56 patients. Infection rates were observed in patients treated nonoperatively and those treated …

Increased Mortality And Reduced Survival In Nonagenarians With Hip Fractures: Implications For Geriatric Care, Roman Austin, Julio Avila, Audrey Wassef, Kate Parker, Katherine Gavin

Western Journal of Orthopaedics

Background: Hip fractures in nonagenarians (patients aged ≥ 90 years) are becoming increasingly common as the population ages, yet outcomes in this group remain poorly characterized. This study compared in-hospital mortality and survivorship at three months, six months, and one year after hip fracture surgery in nonagenarians with a younger elderly cohort aged 65 years to 89 years. Secondary outcomes included fracture characteristics, surgical management, and discharge disposition. Methods: A retrospective chart review was conducted on patients who underwent hip fracture surgery at a single Level I Trauma Center from August 2019 to December 2021. Patients were grouped into nonagenarians …

Massive Upper Extremity Neurofibroma Treated With Limb-Sparing Debulking: A Case Report, Danielle Cummings, Tomas Holy, Nathan Morrell

Western Journal of Orthopaedics

Surgical management of neurofibromas in Neurofibromatosis type 1 (Von Recklinghausen’s disease), can be challenging because tumor size, location, hypervascularity, and tissue friability pose the risk for significant intraoperative and postoperative blood loss. Despite these risks, surgery is often necessary because of functional losses or cosmetic concerns. The authors present a 31-year-old woman with a massive neurofibroma on her right distal forearm, wrist, and hand, who ultimately underwent surgical resection because of functional impairment of her hand. She required postoperative hospitalization and blood transfusion for management of acute blood loss anemia. Because of concerns regarding blood loss and surgical morbidity, the …

Median Nerve Intraneural Hematoma As An Intraoperative Finding During Carpal Tunnel Release: A Case Report, Ana Silva, Gil Gonrtre, Nikalus Skipp, Ana Love, Deana Mercer

Western Journal of Orthopaedics

Carpal tunnel syndrome (CTS) is the most common compressive neuropathy and typically progresses slowly. Intraoperatively, flexor tenosynovitis, nerve edema, or hourglass deformity may be observed. In rare cases, acute compression symptoms occur due to mass effect on the nerve. Intraneural hematoma of the median nerve is uncommon and has been reported primarily in acute CTS cases associated with trauma. This report describes an 87-year-old patient with a history of mild CTS who underwent carpal tunnel release due to worsening symptoms. After the initial incision, a thickened flexor retinaculum, an hourglass deformity of the median nerve, and an intraneural hematoma were …

Proximal Iliotibial Band Rupture In A 74-Year-Old High-Level, Female Athlete: A Case Report, Jeremiah M. Langsfeld, Joseph Esquibel, Dustin L. Richter

Western Journal of Orthopaedics

A 74-year-old female endurance athlete presented with progressive pain over the left proximal and lateral hip distal to the iliac crest. Symptoms developed over three weeks, impairing weightbearing. Magnetic resonance imaging demonstrated a high-grade tear of the proximal iliotibial band at its iliac crest insertion. The patient was treated nonoperatively and returned to high-level, asymptomatic competition three months after symptom onset. This case offers a nonoperative approach to the rare presentation of a proximal iliotibial band rupture.

Arthroscopic Treatment Of Extensive Synovial Chondromatosis Of The Knee: A Case Report, Gaurav Singh, Bhavna Singh, Rebecca Peebles, Justin Bartley

Western Journal of Orthopaedics

Synovial chondromatosis (SC) is a rare, benign monoarticular disorder characterized by intra-articular cartilaginous loose bodies resulting from synovial metaplasia, most commonly affecting the knee. The authors present the case of a 44-year-old man with progressive, debilitating left knee pain, mechanical symptoms, and functional limitations unresponsive to conservative treatment. Radiographs were unremarkable, but magnetic resonance imaging (MRI) demonstrated multifocal noncalcified intra-articular bodies consistent with SC. The patient underwent arthroscopic debridement of the knee with limited synovectomy. Intraoperative findings included innumerable intra-articular cartilaginous loose bodies throughout the knee, synovial proliferation, and grade II chondromalacia. At three months postoperatively, the patient had regained …

Fibula Strut Allograft With Proximal Tibia Autograft For Treatment Of Humerus Nonunion: A Case Report And Review Of Oligotrophic Nonunion Management, Paul Wilson, Naomi Kelley, Samer Kakish

Western Journal of Orthopaedics

Due to their high incidence and frequent need for reoperation, nonunions of the humerus present a significant challenge in orthopaedics. Using fibular struts to treat nonunions have demonstrated excellent results. While fibular autografts provide both biologic and structural benefit, high donor site morbidity must be considered. Although their application in midshaft humeral nonunions remains limited, fibular allografts avoid donor site morbidity. Enhancing fibular strut allografts with biological components offers a promising strategy for treating fractures that have failed prior revisions. This case study presents a 36-year-old woman with an aseptic oligotrophic midshaft humeral nonunion who had an unsuccessful revision surgery. …