Medicine and Health Sciences Commons^™

Postoperative Opioid-Prescribing Practices In Nasal Surgery: A Prospective Study, Brian M. Yan, S. Hamad Sagheer, Cory D. Bovenzi, Uche Nwagu, David Cognetti, Howard Krein, Ryan Heffelfinger

Phase 1

Introduction: Within facial plastic and reconstructive surgery (FPRS), prescription practices have trended toward prescribing larger amounts of perioperative opioids. However, there is limited literature regarding the postoperative pain experience and opioid consumption for FPRS. The purpose of our study was to investigate opioid prescription and consumption following procedures of the nose, with the aim of developing evidence-based guidelines for postoperative pain management.

Methods: In this prospective single center study, morphine milligram equivalents (MME) consumption and pain scores were collected in 72 patients who underwent nasal surgery. Patient demographics, MME use, and pain scores were examined. MME use was compared …

Differences In Clinical And Functional Outcomes Between Osteochondral Allograft Transplantation And Autologous Chondrocyte Implantation When Used In The Treatment Of Focal Grade 3 And Grade 4 Articular Cartilage Defects, Daniel Abraham, Joseph Brutico, Kashyap Chauhan, Anant Dixit, Fotios Tjoumakaris, Brad Tucker, Kevin Freedman

Phase 1

Introduction:

Grade 3 and 4 articular cartilage defects involve 50% of cartilage thickness without involvement of the underlying bone. There are several available options for the surgical repair of articular cartilage lesions including osteochondral allograft transplantation (OCA), a well-established procedure, and autologous chondrocyte implantation (ACI), an alternative developed more recently. Although there are studies examining ACI outcomes, there hasn’t been significant comparison of ACI outcomes to other procedures, including OCA. The inquiry question of this study was: how do clinical and functional outcomes differ between patients with focal articular cartilage defects treated with ACI and patients treated with OCA? …

Total Knee Arthroplasty In Patients With Prior Meniscus Surgery: A Matched Case Control Study, Lasya Rangavajjula, Steven B. Cohen, Md, Meghan E. Bishop, Md, Shyam Brahmabhatt, Md, Michael G. Ciccotti, Md, Ashley Bassett, Md, Christopher Hadley

Phase 1

Introduction: Meniscus surgery is one of the most commonly performed orthopedic surgical procedures in the United States. However, outcomes following a Total Knee Arthroplasty (TKA) in patients with a history of prior knee arthroscopy are varied with small patient cohorts, warranting further research. The research question investigates how the clinical outcomes of TKA compare between patients with and without prior meniscectomy history. It is hypothesized that there will be no significant difference in clinical outcomes between the two cohorts.

Methods: The study design is a retrospective case-control study. The study population included patients from Rothman Institute with TKA and …

Establishing The Relationship Between Mendelian Nafld And Skin Pathology, Anthony Medvedev, Hassan Vahidnezhad, Phd, Leila Youssefian, Phd, Jouni Uitto, Md, Phd

Phase 1

Introduction:

It is estimated that 25% of the world’s population has some form of Nonalcoholic Fatty Liver Disease (NAFLD), a pathology associated with the development of cirrhosis, varices, and hepatocellular carcinoma. The discovery of a biallelic mutation in ABHD5 established the link between NAFLD and Chanarin-Dorfman syndrome. Consequently, it was hypothesized that additional NAFLD-inducing mutations could be associated with dermatologic manifestations.

Methods:

International NAFLD patients from consanguineous families underwent whole exome sequencing. These results were then filtered by frequency and pathogenicity prediction algorithms (e.g. Mutation Taster, Polyphen, CADD) to yield novel mutations. Concurrently, a literature review via PubMed identified …

2021-02-01_Michiganoverview_Covidvaccinestats, Michigan Department Of Health & Human Services

Michigan COVID-19 Vaccine Data

The COVID Vaccine Dashboard page was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus/0,9753,7-406-98178_103214-547150--,00.html.

Data is updated Monday through Saturday. Previously reported numbers of administered vaccine doses may change as new data are received. A possible lag in reporting vaccine doses will result in increases in numbers previously reported.

This report is created by the Michigan Department of Health and Human Services Division of Immunization from data reported to the Michigan Care Improvement Registry (MCIR).

The dashboard contained the tabs Vaccines Shipped, Distribution Trend, Doses Administered, Doses by Vaccine, Doses Metrics, Enrolled Providers, and …

Integrating Depression Management Into Hiv Care In Lilongwe, Malawi: Feasibility And Impact, Brian Wells Pence, Michael Udedi, Kazione Kulisewa, Mina C. Hosseinipour, Steven M. Mphonda, Melissa A. Stockton, Bradley N. Gaynes

HIV and AIDS

In Malawi, as in other sub-Saharan countries, mental health care infrastructure and resources are limited. Accordingly, there is a clear need to shift the provision of mental health treatment to the primary care level. The Malawi Ministry of Health, in partnership with UNC Project-Malawi, designed a program that would integrate depression screening and management into HIV care at two public HIV clinics in Lilongwe, Malawi. The purpose of this study, conducted under Project SOAR, was to evaluate the implementation of this program and its impact on HIV and mental health outcomes.

Misty Rhoads Ijzbtt Editorial Welcome, Misty Rhoads

Journal of Transformative Touch

Editorial Welcome to the IJZBTT from the Executive Editor -Dr. Misty Rhoads-

2021-02-01_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services

Cumulative Michigan COVID-19 Data

The COVID Overview page was obtained from Michigan's main COVID-19 page: https:/www.michigan.gov/coronavirus/0,9753,7-406-98163-520743--,00.html.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled. It is updated Monday - Saturday.
This report is provisional and subject to change. City of Detroit and Wayne County are reported separately. MDHHS began tracking probable cases April 5, 2020. FCI indicates federal correctional institute. MDOC indicates Michigan Department of Corrections. Diagnostic tests, including nucleic acid amplification/real-time polymerase chain reaction (NAAT/RT-PCR) and rapid virus antigen detection point of …

2021-02-01_Michiganoverview_Covidcounts, Michigan Department Of Health & Human Services

Michigan COVID-19 Confirmed Cases by Date of Onset Data

Data was downloaded as an Excel spreadsheet which appeared in the Public Use Datasets section under the Cumulative Data link of Michigan's Coronavirus webpage, under the url https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173---,00.html.

Cases are aggregated by the date of onset of COVID-19 symptoms, if known, otherwise by laboratory specimen date if known, otherwise by case referral date. Deaths are aggregated by the date of death if known, otherwise by the last date of a change to the case status.

Risk Factors And Effect Of Acute Kidney Injury On Outcomes Following Total Hip And Knee Arthroplasty, Zachary S. Aman, Michael Yayac, Alexander J. Rondon, Timothy L. Tan, P. Maxwell Courtney, James J. Purtill

Phase 1

Introduction: Development of acute kidney injury (AKI) following primary total joint arthroplasty (TJA) is a potentially avoidable complication associated with negative outcomes including increased length of stay and mortality. The purpose of this study was to determine the effect of AKI on short-term outcomes and identify risk factors for developing AKI following either total hip or total knee arthroplasty. It was hypothesized that AKI has significant adverse effects on short-term outcomes metrics.

Methods: Patients undergoing primary TJA at a single hospital from 2005 to 2017 were identified and patient demographics, comorbidities, short-term outcomes, and perioperative laboratory results were recorded. …

A Single Academic Center's Experience With Direct Access Colonoscopy, Rachel Israilevich, Mary White, Sophia Lam, Benjamin Chipkin, David Kastenberg, Md

Phase 1

Introduction: Direct Access Colonoscopy (DAC) does not require pre-colonoscopy consultation and may improve access for patients needing screening and surveillance. DAC eligibility criteria vary widely, and we developed a novel, DAC program using EMR patient data to assess appropriateness for inclusion. This study aimed to evaluate the efficacy and quality of our DAC program and compare to traditional, Office-Scheduled Colonoscopy (OSC).

Methods: We conducted a retrospective, single-center study of OSC and DAC patients ages 45-75 with a screening or surveillance indication over 13 months. Primary outcome was Complete Colonoscopy (CC): to cecum/ileum/anastomosis, adequate prep, < 90 days from gastroenterology contact. Patients not meeting CC criteria were classified as Incomplete Colonoscopy (IC). Secondary endpoints: time to CC, adenoma detection rate (ADR).

Results: 2,651 patients met …

Success Of Preoperative Radiotherapy In Inflammatory Breast Cancer With Inadequate Response To Taxane-Based Chemotherapies, Paul Forrest, Christian Fernandez, Md, Ayesha Ali, Md, Ryan C. Miller, Md, Rebecca J. Jaslow, Md, Melissa A. Lazar, Md, Pramila R. Anne, Md, Adam C. Berger, Md, Massimo Cristofanilli, Md, Nicole L Simone, Md

Phase 1

Inflammatory breast cancer is a locally-aggressive and highly malignant cancer which often carries a poor prognosis for afflicted patients. Multi-modality treatment is often required, and taxane-based chemotherapy has shown improved outcomes and allowed for the pursuit of mastectomies, which are critical to disease control. Inadequate response to taxane-based chemotherapy indicates aggressive disease, and the role of preoperative radiotherapy for treatment in this patient group and its effects on patient outcomes and toxicity has not been studied. This study evaluates the effectiveness of preoperative radiotherapy on this patient group. Inflammatory breast cancer patients between 2012-2018 who were not deemed appropriate for …

Evaluation Of Arthroscopic Repair To Pan-Labral Lesions Of The Glenoid: A Retrospective Review Of Patient Outcomes Over A Ten-Year Period And Matched Cohort Analysis, Julien Aoyama, Joseph Schmitz, Christopher Hadley, Meghan Bishop, Md, Brandon Erickson, Md, Sommer Hammoud, Md

Phase 1

Introduction:

Most shoulder labral tears are partial and treated with surgery, but rarely they are “panlabral” around the entire shoulder. Due to infrequency panlabral tears aren’t well understood, and thus this study compares outcomes between panlabral and more common SLAP tears. We hypothesize no difference in outcomes based on surgeon experiences.

Methods:

This is a retrospective cohort study of shoulder labrum repairs at Rothman Institute from 2006-2016. All patients received arthroscopic repair and were categorized to compare panlabral to SLAP tears. The primary outcome is return-to-activity rate at six months post-surgery and secondary outcomes include post-operative range of motion, …

Callicore, Cole Miller, Galen Ogg, Jasmine Phun, Yajnesh Vedanaparti, Morgan Hutchinson, Md

Phase 1

Transporting children in SPICA casts in a safe, comfortable, and convenient manner so that the parents can feel more at ease.

The Development Of A Multiple Errands Test For Pre/Post Concussive Testing On A College Campus: The University Multiple Errands Test - Lessons Learned, Regula H. Robnett, Kathleen Hahn, Tetee Roland

Occupational Therapy Faculty Publications

The Multiple Errands Test (MET) is an occupation-based assessment tool, used to determine if someone who has sustained an acquired brain injury can successfully complete everyday errands, such as purchasing items at a gift shop, mailing a letter, and determining what hours a store is open. The MET has been used successfully in a hospital setting. Due to the MET’s ecological validity, we sought to determine if an adapted MET (revised for a college campus setting) would be an appropriate alternative to the ImPACT, an often-required, on-line pre and post-concussion neuropsychological assessment for high school and college athletes. Students may …

2021-02-01_Michigandaily_Covidmap, Michigan Department Of Health & Human Services

Daily Michigan COVID-19 Update

The "WHERE WE STAND WITH COVID-19" map was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily at 3p.m., Monday - Saturday.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled.

The image contained a map, indicating total cases by county, and also provides statistics on Total Confirmed Cases, Total COVID-19 Deaths, Daily Confirmed Cases, and Daily COVID-19 Deaths. There …

The Association Of "Loss Of Smell" To Covid-19: A Systematic Review And Meta-Analysis., Muhammad Aziz, Hemant Goyal, Hossein Haghbin, Wade M Lee-Smith, Mahesh Gajendran, Abhilash Perisetti Md

Other Specialties

BACKGROUND: The presence of olfactory dysfunction or "loss of smell" has been reported as an atypical symptom in patients with coronavirus disease 2019 (COVID-19). We performed a systematic review and meta-analysis of the available literature to evaluate the prevalence of "loss of smell" in COVID-19 as well as its utility for prognosticating the disease severity.

METHODS: An exhaustive search of the PubMed/Medline, Embase, Web of Science, Cochrane Library, LitCovid NIH, and WHO COVID-19 database was conducted through August 6

RESULTS: A total of 51 studies with 11074 confirmed COVID-19 patients were included. Of these, 21 studies used a control group …

Bullied By Covid’S Isolation, Anonymous

Community Reflections

Class assignment for Professor Marino, Western Civilization. My content is a self reflection of the obstacles that COVID 19 presented to me, specifically isolation. The time period is from November - January 2020-2021. The location was campus at Sacred Heart University and describes the feeling of being isolated away from the view of a simple human smile that can bring comfort and acceptance to someone. Having the freedom of enjoying the company of others taken away from you.

Defining The Genotypic And Phenotypic Spectrum Of X-Linked Msl3-Related Disorder, Theresa Brunet, Kirsty Mcwalter, Katharina Mayerhanser, Grace M Anbouba, Amy Armstrong-Javors, Ingrid Bader, Evan Baugh, Amber Begtrup, Caleb P Bupp, Bert L Callewaert, Anna Cereda, Margot A Cousin, Juan C Del Rey Jimenez, Laurie Demmer, Nikita R Dsouza, Nicole Fleischer, Ralitza H Gavrilova, Sumedha Ghate, Elisabeth Graf, Andrew Green, Sarah R Green, Maria Iascone, Ameni Kdissa, Dirk Klee, Eric W Klee, Emily Lancaster, Kristin Lindstrom, Johannes A Mayr, Meriel Mcentagart, Naomi J L Meeks, Dana Mittag, Harrison Moore, Anne K Olsen, Damara Ortiz, Gretchen Parsons, Loren D M Pena, Richard E Person, Sumit Punj, Gonzalo Alonso Ramos-Rivera, Maria J Guillen Sacoto, G Bradley Schaefer, Rhonda E Schnur, Tiana M Scott, Daryl A Scott, Carolyn R Serbinski, Vandana Shashi, Victoria Mok Siu, Barbro Fossøy Stadheim, Jennifer A Sullivan, Jana Švantnerová, Lea Velsher, David S Wargowski, Ingrid M Wentzensen, Dagmar Wieczorek, Juliane Winkelmann, Patrick Yap, Michael Zech, Michael T Zimmermann, Thomas Meitinger, Felix Distelmaier, Matias Wagner

Paediatrics Publications

PURPOSE: We sought to delineate the genotypic and phenotypic spectrum of female and male individuals with X-linked, MSL3-related disorder (Basilicata-Akhtar syndrome).

METHODS: Twenty-five individuals (15 males, 10 females) with causative variants in MSL3 were ascertained through exome or genome sequencing at ten different sequencing centers.

RESULTS: We identified multiple variant types in MSL3 (ten nonsense, six frameshift, four splice site, three missense, one in-frame-deletion, one multi-exon deletion), most proven to be de novo, and clustering in the terminal eight exons suggesting that truncating variants in the first five exons might be compensated by an alternative MSL3 transcript. Three-dimensional modeling of …

The Role Of Panx3 In Age-Associated And Injury-Induced Intervertebral Disc Degeneration, Meaghan Serjeant, Paxton M. Moon, Diana Quinonez, Silvia Penuela, Frank Beier, Cheryle A. Séguin

Physiology and Pharmacology Publications

© 2021 by the authors. Licensee MDPI, Basel, Switzerland. Pannexin 3 (Panx3) is a mechanosensitive, channel-forming glycoprotein implicated in the progression of post-traumatic osteoarthritis. Despite evidence for Panx3 expression in the intervertebral disc (IVD), its function in this cartilaginous joint structure remained unknown. Using Panx3 knockout mice, this study investigated the role of Panx3 in age-associated IVD degeneration and degeneration induced by annulus fibrosus (AF) needle puncture. Loss of Panx3 did not significantly impact the progression of age-associated histopathological IVD degeneration; however, loss of Panx3 was associated with decreased gene expression of Acan, Col1a1, Mmp13 and Runx2 and altered localization …

Total Knee Replacement After High Tibial Osteotomy: Time-To-Event Analysis And Predictors, Codie A. Primeau, Trevor B. Birmingham, Kristyn M. Leitch, Kevin R. Willits, Robert B. Litchfield, Peter J. Fowler, Jacquelyn D. Marsh, Bert M. Chesworth, Stephanie N. Dixon, Dianne M. Bryant, J. Robert Giffin

Bone and Joint Institute

© 2021 Joule Inc. or its licensors. BACKGROUND: An important aim of high tibial osteotomy (HTO) is to prevent or delay the need for total knee replacement (TKR). We sought to estimate the frequency and timing of conversion from HTO to TKR and the factors associated with it. METHODS: We prospectively evaluated patients with osteoarthritis (OA) of the knee who underwent medial opening wedge HTO from 2002 to 2014 and analyzed the cumulative incidence of TKR in July 2019. The presence or absence of TKR on the HTO limb was identified from the orthopedic surgery reports and knee radiographs contained …

Combined Medial Patellofemoral Ligament And Medial Patellotibial Ligament Reconstruction For Recurrent Lateral Patellar Dislocation In Flexion, Taher Abdelrahman, Gilbert Moatshe, Elizabeth Arendt, Julian Feller, Alan Getgood

Bone and Joint Institute

© 2020 Arthroscopy Association of North America Recurrent lateral patellar dislocation can be a challenging entity to manage. It results from an imbalance between the restraints to lateralization of the patella and the forces applied to the patella within the biomechanical environment of the knee. The medial patellofemoral ligament has been recognized as the most important static soft-tissue restraint. However, the medial patellotibial ligament and medial patellomeniscal ligament are important for patellar stability at higher degrees of knee flexion. Lateral patellar dislocation in flexion poses a particularly challenging clinical entity with a combination of unique characteristics that need to be …

Schrödinger Filtering: A Precise Eeg Despiking Technique For Eeg-Fmri Gradient Artifact, Gabriel B. Benigno, Ravi S. Menon, Hacene Serrai

Brain and Mind Institute Researchers' Publications

In EEG data acquired in the presence of fMRI, gradient-related spike artifacts contaminate the signal following the common preprocessing step of average artifact subtraction. Spike artifacts compromise EEG data quality since they overlap with the EEG signal in frequency, thereby confounding frequency-based inferences on activity. As well, spike artifacts can inflate or deflate correlations among time series, thereby confounding inferences on functional connectivity. We present Schrödinger filtering, which uses the Schrödinger equation to decompose the spike-containing input. The basis functions of the decomposition are localized and pulse-shaped, and selectively capture the various input peaks, with the spike components clustered at …

Cracking The Code Of Place Value: The Relationship Between Place And Value Takes Years To Master, Pierina Cheung, Daniel Ansari

Brain and Mind Institute Researchers' Publications

Place value, which underlies the meanings of multidigits, encompasses the principle of position and base-10 rules. To understand 65, one needs to know that the digits 6 and 5 occupy different positions and thus represent ordered values of different magnitudes (i.e., the principle of position) and that the value of each position is determined by base-10 rules (i.e., the rightmost position is 100, followed by 101, 102, etc.). Without the principle of position, children cannot construct meanings for multidigits. Previous studies have shown that children do not know the exact value of digit positions until the early elementary school years, …

Development Of A Mortality Prediction Tool In Pediatric Severe Traumatic Brain Injury, Douglas Fraser

Data and Test Instruments

No abstract provided.

Himmelfarb Library Liaison Letter - February 2021, George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Library Liaison Letters

No abstract provided.

Expanding The Whipple Accelerated Recovery Pathway (Warp) To All Patients Undergoing Pancreaticoduodenectomy (Pd), Ava Torjani, Clifford Yudkoff, Taylor R. Kavanagh, Wilbur Bowne, Geoffrey Krampitz, Hamza Rshaidat, Cyrus J. Sholevar, Alexandra C. Leto, William Preston, Elwin Tham, Mandeep Shergill, Shawnna Cannaday, Theresa Yeo, Harish Lavu, Charles J. Yeo

Phase 1

Introduction

Enhanced recovery after surgery constitutes a multi-disciplinary approach to reduce length of stay (LOS), post-operative complications (POCs), and readmission rate (RR). This not only improves patient outcomes, but also reduces hospital costs. The Whipple Accelerated Recovery Pathway (WARP) trial successfully reduced LOS without increasing the rate of POCs and RR in patients undergoing pancreaticoduodenectomy (PD). However, the study was limited to a highly selective group of patients. This study aimed to determine if WARP could be expanded to all patients undergoing PD.

Methods

A single-institution retrospective review of 281 patients who underwent PD between 2017-2020 was conducted. Patients were …

Assessment For Simulation Training For Prehospital Ems Providers In Bermuda, David Duperreault, Roger Band, Md, Amy Gutman, Md, Dimitri Papanagnou, Md

Phase 1

Introduction

The island of Bermuda is 21 sq miles and located approximately 650 miles east of North Carolina, US. ^[1] There is only one hospital to serve the population of approximately 65,000. There are approximately 95 registered EMTs (Emergency Medical Technician) and AEMTs (Advanced Emergency Medical Technician) currently serving the island. ^[2] It is hypothesized that due to the remote/isolated nature of the island, low ratio of 911 call volume to population, and limited access to continuing education, there is difficulties for EMTs and AEMTs to maintain their skill and knowledge base. ^{[3, 4, 5, 6]} The Goal of this …

Psychiatrist Burnout, Irvin Sam Schonfeld, Renzo Bianchi

Publications and Research

We critique a paper published by Summers et al. (2020) and papers in general that, because of flawed methods, arrive at exceedingly high estimates of burnout in psychiatrists and other professionals.

Capacity Of Rural Counties To Address An Hiv Or Hepatitis C Outbreak, Jennifer Lenardson Mhs, Jaclyn Janis Rn, Mph, Amanda Burgess Mppm, Karen Pearson Mlis, Ma, Martha Elbaum Mpa

Population Health

HIV and hepatitis C (HCV) are major public health concerns in the United States and are a focus of significant federal health policy attention. Rural counties may be potentially vulnerable to an HIV or HCV outbreak among persons who inject drugs due to greater prevalence of high-risk injection practices as well as limited public health capacity to prevent, prepare for, and respond to an HIV or HCV outbreak. This study identified states potentially at risk for an HIV or HCV outbreak and used data from the 2016 Association of State and Territorial Health Officials (ASTHO) Profile Survey, 2016 National Association …