Medicine and Health Sciences Commons^™

American Society Of Hematology/International Society On Thrombosis And Haemostasis 2024 Updated Guidelines For Treatment Of Venous Thromboembolism In Pediatric Patients, Paul Monagle, Muayad Azzam, Rachel Bercovitz, Marisol Betensky, Rukhmi Bhat, Tina Biss, Brian Branchford, Leonardo R. Brandão, Anthony K.C. Chan, E. Vincent S. Faustino, Julie Jaffray, Sophie Jones, Hassan Kawtharany, Bryce A. Kerlin, Nicole Kucine, Riten Kumar, Christoph Male, Marie-Claude Pelland-Marcotte, Leslie Raffini, Chittalsinh M. Raulji, Sarah E. Sartain, Clifford M. Takemoto, Cristina Tarango, C. Heleen Van Ommen, Maria C. Velez, Sara K. Vesely, John Wiernikowski, Suzan Williams, Hope P. Wilson, Gary Woods, Ayesha Zia, Reem A. Mustafa

Journal Articles: Pediatrics

BACKGROUND: The American Society of Hematology (ASH) guidelines on treatment of pediatric venous thromboembolism (VTE) were published in 2018. In the last 6 years, there has been a 10-fold increase in the number of children involved in VTE treatment trials.

OBJECTIVE: The ASH Committee on Quality and Guidelines agreed to update the pediatric guidelines in conjunction with the International Society on Thrombosis and Haemostasis (ISTH). These ASH/ISTH evidence-based guidelines are intended to support patients, clinicians, and other health care professionals in the management of pediatric patients with VTE.

METHODS: ASH/ISTH formed a multidisciplinary guideline panel to minimize potential bias from …

Introducing The University Of New Mexico 12-Level Functional Scale: A Novel Approach For Assessing Functional Recovery In Orthopaedic Trauma Patients, Devin A. Maez, Rick J. Gehlert, Thomas A. Decoster

Western Journal of Orthopaedics

The University of California at Los Angeles (UCLA) Activity Scale and other common activity scales are primarily used for patients undergoing joint reconstructive surgery. However, no such scale exists for musculoskeletal trauma patients. The authors propose The University of New Mexico (UNM) 12-Level Functional Activity Scale to address this gap in assessing functional activity and managing postoperative care for orthopaedic trauma patients. A comprehensive review of existing scales led to the development of the UNM Scale, emphasizing simplicity, objectivity, and potential benefits in patient education and interdisciplinary collaboration. The UNM Scale provides a structured approach to assess and monitor functional …

Fluoroscopy-Guided Versus 3d Navigated Percutaneous Sacroiliac Screw Fixation: A Comparison Of Radiation Exposure And Surgical Duration, Tyler J. Chavez, Jeremiah M. Langsfeld, Solomon Oloyede, Gordon H. Lee, Urvij Modhia

Western Journal of Orthopaedics

Background: Pelvic ring injuries are complex surgical challenges requiring significant radiation exposure for safe placement of sacroiliac (SI) screw fixation. Traditionally, SI fixation has been performed with conventional C-arm fluoroscopy to guide screw placement. 3D navigated imaging is a technique that uses fluoroscopic scans and a navigation tracker to guide screws in space. The purpose of this study is to characterize a single institution’s experience with navigated SI fixation and the resulting radiation exposure to patient and staff. Methods: Records of 60 patients who underwent SI fixation using either conventional fluoroscopy (43) or 3D navigation (17) were reviewed. Exposure data …

Fishtail Deformity Complication Of Distal Humeral Fractures In Children, Jorge E. Licano, Ryan Price, Devin A. Maez, Selina A. Silva

Western Journal of Orthopaedics

Background: Pelvic ring injuries are complex surgical challenges requiring significant radiation exposure for safe placement of sacroiliac (SI) screw fixation. Traditionally, SI fixation has been performed with conventional C-arm fluoroscopy to guide screw placement. 3D navigated imaging is a technique that uses fluoroscopic scans and a navigation tracker to guide screws in space. The purpose of this study is to characterize a single institution’s experience with navigated SI fixation and the resulting radiation exposure to patient and staff. Methods: Records of 60 patients who underwent SI fixation using either conventional fluoroscopy (43) or 3D navigation (17) were reviewed. Exposure data …

Rare Case Of Fungal Osteomyelitis Affecting An Intramedullary Lag Screw, Matthew C. Watterson, Robert T. Rella, Timothy K. Summers, David Michaeli, Jess Mullens

Western Journal of Orthopaedics

Osteomyelitis is an infection of the bone that is most commonly of bacterial origin. Cases of fungal osteomyelitis are rare, and treatment often requires a prolonged course of antimicrobials. The authors report a case of a 72-year old man with fungal osteomyelitis affecting an intracortical lag screw, which was discovered during fixation of the left femoral shaft following an injury that occurred 68 years after placement of the affected lag screw. Chronic osteomyelitis can be indolent and subclinical, with the patient experiencing no signs or symptoms of the disease despite having bone infection for decades. This condition may become clinically …

Closed Treatment Of Displaced Radial Neck Fracture In An Adult, Nicholas Newcomb, Tomas Holy, Naomi Kelley, Nathan T. Morrell

Western Journal of Orthopaedics

Making up 1.5% to 4.0% of all fractures, radial head and neck fractures are typically treated based on the severity of angulation at the radial neck or if range of motion (ROM) is blocked. In this study, we present a case of a 43-year old woman with a Mason Type 2 radial neck fracture, successfully treated with closed reduction and one week of immobilization, resulting in near anatomic radial neck angulation without the need for operative intervention. The patient returned to work within two weeks and regained full ROM by six months, maintaining near anatomic reduction throughout. Keywords: Elbow Injury; …

Two-Stage Total Knee Arthroplasty (Tka) For A Rigid And Infected Knee: A Rare Case Report Of Aspergillosis, Túlio Vinícius De Oliveira Campos, David G. Kasuya Barbosa, Victor A. Kasuya Barbosa, Santiago Enrique Sarmiento Molina, Guilherme Moreira De Abreu Silva, Marco Antônio Percope De Andrade

Western Journal of Orthopaedics

Knee infection caused by Aspergillus is a rare condition that presents a diagnostic challenge for orthopaedic surgeons and musculoskeletal specialists. This case report aims to describe the treatment of a patient with active articular Aspergillus infection and knee arthrofibrosis through a two-stage total knee arthroplasty (TKA). A 37-year old woman presented with knee arthrofibrosis, which was complicated by an Aspergillus infection. The treatment involved a two-stage procedure: 1) bone cuts for TKA and systemic antibiotic therapy; and 2) TKA with the use of specific antibiotic-loaded cement. The patient has been followed for 30 months, showing no signs of failure.

Proximal Tibia Biplanar Anterior And Lateral Closing Wedge Osteotomy With Concomitant Revision Anterior Cruciate Ligament Reconstruction: A Case Report, Shane H. Johns, Lisandro Nardin, Jessica A. Nelson, Robert Schenck

Western Journal of Orthopaedics

This report documents a unique, successful strategy to manage a failed anterior cruciate ligament reconstruction (ACLR) in the setting of coronal and sagittal plane malalignment. The patient is a 38-year-old man with a history of a failed ACLR who presented with recurrent knee instability. Imaging revealed a posterior tibial slope (PTS) of 17° complicated by a varus malalignment of 10°. A single-stage anterior and lateral closing wedge tibial osteotomy (biplanar) with simultaneous revision anterior cruciate ligament reconstruction was performed. Final radiographic evaluation revealed that the tibial osteotomy healed with correction of coronal alignment to a physiologic 3° varus and a …

Recurrent Baker’S Cyst In A Pediatric Athlete: A Case Report, Gaurav Singh, Rebecca Peebles, Justin Bartley

Western Journal of Orthopaedics

Also known as popliteal cysts, Baker’s cysts are fluid-filled lesions found in the popliteal fossa, typically originating from the gastrocnemius-semimembranosus bursa. While these cysts are relatively common in adults, with a prevalence ranging from 5.0% to 41.0%, they are extremely rare in children, showing an incidence of just 2.4%. In most cases, Baker’s cysts result from intra-articular knee pathologies that lead to an increased production and sequestration of synovial fluid. The authors present the case of an athletic 16-year-old adolescent boy with a recurrent left-knee Baker’s cyst with magnetic resonance imaging showing no intra-articular pathology. Despite conservative treatment, including non-steroidal …

Treatment Of Congenital Cruciate Ligament Absence In A Teenager Knee-Ding Stability, Gaurav Singh, Anna Bergquist, Rebecca Peebles, Justin Bartley

Western Journal of Orthopaedics

The congenital absence of the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) is an extremely rare condition, with an estimated prevalence of 0.017 per 1,000 live births for ACL agenesis. The authors present the case of a 15-year-old adolescent girl with autosomal dominant multiple synostosis, who developed progressive bilateral knee pain and functional limitations. Bilateral knee x-rays revealed trochlear dysplasia and an absent tibial eminence, suggesting a congenital ligamentous abnormality. Magnetic resonance imaging confirmed the bilateral absence of both the ACL and PCL. Surgical reconstruction of both ligaments was performed, with the first procedure taking place in October …

Assessing Reproductive Health In Zoo-Managed African Elephant Bulls (Loxodonta Africana), Kaitlyn Marie Campbell

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Populations of zoo-managed African elephant (Loxodonta Africana) exhibit substantial individual- and population-level variation in reproductive success, yet research has largely focused on females, leaving male fertility poorly understood. Subfertility in bulls, characterized by low libido and inconsistent semen quality, poses significant challenges to genetic management and long-term population sustainability. This study a) systematically evaluates semen quality, b) identifies physiological, behavioral, social, and environmental determinants of fertility, and c) advances ex situ conservation through the expansion of the African elephant sperm bank. Between January 2023 and July 2025, 209 semen collection events were conducted from 13 sexually mature bulls …

Healthy Here Family Healthy Weight Program Year 1 Summary, Camille R. Velarde, Courtney A. Fitzgerald, Theresa H. Cruz

Reports & Documents

No abstract provided.

Ber Anena’S Vagina Diaries, A Review: An African Student’S Encounter With The American Health System, Akua Agyeiwaa Denkyi-Manieson

Department of English: Dissertations, Theses, and Student Research

This work delves into the disappointment, indifference, and pretense experienced by the narrator when she sorts the American healthcare system. It also addresses the struggles immigrants face, particularly from Africa, as they navigate a healthcare system that often requires them to prove their pain and worthiness of attention. The narrative emphasizes the importance of not generalizing the entire healthcare system based on a single negative experience while acknowledging the profound impact on one's perception of the system. Furthermore, it explores the paradox between the availability of better resources in America compared to the narrator's home country and the mistreatment and …

Effect Of Integrated Neuromuscular Inhibition Technique On Iliotibial Band Friction Syndrome, Esraa Tarek Farouk Ahmed, Amir Mohamed Saleh, Hassan Hussien Ahmed, Doaa Rafat El Azab

Journal of Medicine in Scientific Research

Background: It was reported that, 25% of adults experience limited mobility and a diminished quality of life due to knee pain. The iliotibial band friction syndrome (ITBFS) is a frequent overuse injury that causes lateral knee pain. It is marked by recurrent lateral knee pain as well as motor impairment in the lower extremities. Pain worsens with exercise and weight-bearing activities, especially at 30° of knee flexion, and patients usually have a history of overuse caused by knee flexion and extension.Objective: To determine the impact of the integrated neuromuscular inhibition technique on pain intensity, knee range of motion and knee …

Endoscopic Management Of Third Ventricular Colloid Cysts: Efficacy, Safety, Technique, Result, And Limitations, Mohammad Abdulsalam Soliman

Journal of Medicine in Scientific Research

Background: Colloid cysts of the third ventricle are rare, benign lesions that may cause life-threatening obstructive hydrocephalus. Full-endoscopic resection has emerged as a minimally invasive alternative to microsurgical approaches. This study evaluates the surgical outcomes and safety profile of the trans-frontal endoscopic technique, with emphasis on the swiveling technique for capsule excision. Methods: This retrospective and prospective cohort study included 24 patients who underwent full-endoscopic trans-frontal resection of third ventricular colloid cysts at Al- Ahrar Teaching Hospital, a tertiary neurosurgical center in Egypt, between January 2016 and December 2024. All procedures were performed using a 6° angled rigid neuroendoscopy with …

The Importance Of Trunk Motion In Wearable Based Infant Spontaneous Movement Analysis, Pablo Burgos

Faculty Publications - College of Physical Therapy

The characteristics of spontaneous movements in infants are essential for the early detection of neurological pathologies, with the Prechtl method being a widely recognized approach. While the Prechtl method is effective in predicting motor risks, its reliance on the evaluator’s expertise limits its scalability, particularly in low-income areas. In such contexts, the use of inertial sensors combined with automated analysis presents a promising accessible alternative; however, more research is necessary to get results comparable to those of the Precht method. This research aims to determine the more important metrics of trunk and limbs to assess spontaneous movement in healthy infants …

Cognition Is Associated With Daily-Life Mobility In People With Parkinson’S Disease, Pablo Burgos

Faculty Publications - College of Physical Therapy

Introduction: Cognitive impairment is common in people with Parkinson’s disease (PD). Mobility is also impaired in people with PD and functional mobility often requires cognitive dual-tasking to navigate complex environments in daily life. We hypothesized that visuospatial and executive cognitive dysfunction in people with PD will be associated with digital measures of mobility in daily life. Since freezing of gait (FoG) is associated with both cognitive dysfunction and mobility impairments, we also examined the influence of FoG on the cognitionmobility relationship. Here, we investigated, for the first time, the association between cognition and dailylife mobility in PD and the influence …

Responsiveness Of Promis Measures For Hip, Knee, And Shoulder Arthroplasty, Ryan Jacobson

Faculty Publications - College of Physical Therapy

Objectives: In hip, knee, and shoulder arthroplasty, there is evidence that using a broader set of Patient-Reported Outcomes Measurement Information System (PROMIS) measures beyond Physical Function and Pain Interference might improve assessment of patient outcomes. However, the utility and responsiveness of PROMIS domains measuring anxiety, fatigue, sleep, and social participation have been minimally investigated in arthroplasty. This retrospective study aimed to determine the 1) responsiveness of seven PROMIS domains and 2) association between change scores for all seven domains and MCID improvement in Physical Function and/or Pain Interference.

Methods: PROMIS domains of Physical Function, Pain Interference, Depression, Anxiety, Fatigue, Sleep …

The Use Of Virtual Reality To Improve Gait And Balance In Patients With Parkinson’S Disease: A Scoping Review, Jason Brumitt

Faculty Publications - College of Physical Therapy

(1) Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder that impairs balance and postural control, gait, overall motor function, and mood, and involves the gradual degradation of several physiologic systems. With limited treatments available, physical therapy (PT)-based exercise is the nonpharmacologic measure of choice. There is a growing interest in using virtual reality (VR) gaming when rehabilitating patients with various acute brain injuries and neurological disorders. The purpose of this scoping review was to examine randomized controlled trials comparing VR-based rehabilitation programs versus traditional PT at improving gait and balance. (2) Methods: PubMed, CINAHL, and the Cochrane Central Register …

Personalized Versus Fixed Tactile Cueing In Parkinson’S Disease: Protocol For A Randomized Controlled Trial On Gait Automaticity, Pablo Burgos

Faculty Publications - College of Physical Therapy

Background

Gait automaticity, the ability of the brain to control locomotion with minimal use of executive-attentional resources, is altered in people with Parkinson’s disease (PD). Recently, we showed that step-synchronized tactile cueing improved gait regularity and freezing of gait in PD; however, it is not known if this cueing mode also improves gait automaticity. Thus, this study investigates the effects of step-synchronized tactile cueing (versus fixed cueing) on gait automaticity in the laboratory and during daily life.

Methods

This is a pilot, randomized, double-blinded study where sixty participants with PD will be randomized into one of two, cueing interventions: 1) …

Prevalence Of Stress Urinary Incontinence In Female Strength Athletes, Jason Brumitt

Faculty Publications - College of Physical Therapy

Background: Stress urinary incontinence (SUI) is a symptom during pregnancy and in the postpartum period, but a high prevalence of SUI is experienced in sports involving running and jumping. Objectives: Identify the scope of the problem of SUI in women participating in strength sports, movement patterns that elicit SUI, and the impact on quality of life in female athletes with SUI. Study Design: Survey mixed methods with qualitative focus groups. Methods: The International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) and a sport-specific and obstetric/gynecological history questionnaire were sent to women who are United States citizens, age 18-65, and members …

A Historic Case Of Relapsing-Remitting Alzheimer's Disease In An Adolescent Attributed To Scarlet Fever., Richard Lathe, Brian J. Balin

PCOM Scholarly Works

We draw attention to a historic case of a boy who suffered from scarlet fever (typically caused by the bacterium Streptococcus pyogenes) at age 7 years and went on to develop the symptoms of Alzheimer's disease (AD). His physicians believed that the subsequent dementia was related to the infection. After death at 24 years of age, postmortem brain examination revealed abundant AD-type senile plaques and fibrils, formally confirming AD. Other potential causes of early-onset dementia are discussed, but these are distinct from patient E.H. This case is pertinent regarding the current debate about the potential role of infection in …

Development Of An Ecg-Based Deep Learning Model For Pediatric Congenital Heart Disease (Chd) Diagnosis, Annbar Mekouar

Selected Full-Text Master Theses 2021-

Congenital heart disease (CHD) stands as the leading congenital anomaly which affects pediatric populations throughout the world. The effectiveness of treatment depends on both early diagnosis and accurate identification but echocardiography requires manual interpretation which proves time-consuming and inconsistent especially when examining pediatric patients with their distinct cardiac systems. The research aims to create a deep learning-based diagnostic framework which uses ECG data to identify coronary artery disease subtypes in pediatric patients. The model uses high-quality datasets from Dr. Ignacio Lugones to extract R-R intervals and QRS durations through convolutional neural networks (CNNs). The system addresses pediatric-specific challenges while enhancing …

Preliminary Evaluation Of Bahamian Botanicals For Tropical Applications, Michelle Antoinette Outten

Selected Full-Text Master Theses 2021-

This thesis explores the phytochemical composition and cosmetic potential of three Bahamian botanicals- Mosiera longipes (MLE), Tabebuia bahamensis (TBE), and Momordica charantia (MCE)---traditionally used in local bush medicine. Methanolic and aqueous extracts were prepared and incorporated into topical cream formulations. While HPLC-DAD analysis was performed, no compounds were definitively identified due to hardware limitations; chromatographic data remain preliminary, providing a foundation for future validation. Formulations were assessed for stability under centrifugation, thermal cycling, and long-term storage. All samples demonstrated acceptable initial pH values within the skin-compatible range (4.5-5.5): BWE (5.63 ± 0.04), TBE (5.47 ± 0.02), MLE (5.72 ± 0.04), …

Weight Stigma In Physical And Occupational Therapy: A Scoping Review, Jason Brumitt

Faculty Publications - College of Physical Therapy

Background: Weight stigma describes the negative attitudes held toward people with obesity. Weight bias stereotypes have been previously reported in physicians, physician assistants, nurses, registered dieticians, psychologists, and students enrolled in healthcare professional education programs. Physical and occupational therapists (PTs and OTs) are healthcare providers who evaluate and treat individuals across their lifespan. A PT or an OT who harbors weight bias may create an environment where the patient may fail to optimize their rehabilitation recovery. The first purpose of this scoping review was to identify the prevalence of weight bias in PT and OT clinicians and students. The second …

Demographic And Clinical Characteristics Of Patients With Charcot Neuro-Osteoarthropathy In People With Diabetes Mellitus In Six Countries: A Multicenter Observational Study From 1996 To 2022, E. B. Jude, C. Siafarikas, A. Rastogi, R. Bem, T. Tankova, M. -F. Kong, Javier La Fontaine, J. Pappachan, N. Tentolouris

School of Podiatric Medicine Publications

Aim: To describe the demographic and clinical characteristics of patients with Charcot neuro-osteoarthropathy (CNO) and to examine for differences between participants with Type 1 diabetes mellitus (DM) (T1DM) and Type 2 diabetes mellitus (T2DM).

Materials and Methods: Multicenter observational study in eight diabetic foot clinics in six countries between January 1, 1996, and December 31, 2022. Demographic, clinical, and laboratory parameters were obtained from the medical records. Analyses were performed using parametric or nonparametric statistical tests for variables with normally or nonnormally distributed values, respectively. Comparisons of the qualitative data were performed using the chi-square test.

Results: Seven hundred seventy-four …

Rare Case Of Osteomyelitis Caused By Achromobacter Xylosoxidans, Christopher P. Girgis, Tyler L. Coye, Elizabeth Ansert, Amanda L. Killeen, Peter A. Crisologo

School of Podiatric Medicine Publications

Achromobacter xylosoxidans is a rare opportunistic aerobe that has rarely been documented in the literature as a causative agent for osteomyelitis. It can present with antibiotic resistance, making treatment without operative management challenging. We present the case of a 51-year-old male with a past medical history of uncontrolled type 2 diabetes. The patient presented to a clinic with a grade 2 infection to the right fifth digit, as defined by the International Working Group on the Diabetic Foot, and was subsequently admitted for intravenous antibiotics and operative management. Magnetic resonance imaging revealed abnormal signal of the phalanges of the fifth …

Comparative Effectiveness Of Conservative Versus Early Surgical Treatments On Wound Healing Outcomes Of Diabetic Foot Ulcers: A Literature Review, Paul Tran, Yasim Zafar, Andrea Piña, Stephanie N. Campbell

School of Podiatric Medicine Publications

Diabetic foot ulcers (DFUs) are a severe complication of diabetes mellitus and the leading cause of lower extremity amputations worldwide. Peripheral neuropathy and peripheral arterial disease secondary to complications of diabetes mellitus may result in ulcers going unnoticed, increasing the risk of severe osteomyelitis, necrotizing infection, hospitalization, amputation, and sepsis. While conservative management of DFUs remains the first-line approach—emphasizing wound care, infection control, glycemic management, and offloading—there is growing debate about whether delaying simple surgical interventions worsens long-term outcomes. Surgeries such as tenotomy, digital amputation, and tendo-Achilles lengthening are minimally invasive options that can correct deformities, prevent recurrence, and promote …

Residual Next-Day Effects Of Alprazolam On Psychomotor Performance And Simulated Driving In Healthy Normal Adults, Stevie C. Roszkowski, Shanna Babalonis, Marion A. Coe, Paul Nuzzo, Michelle R. Lofwall, Laura C. Fanucchi, Sharon L. Walsh

Center on Drug and Alcohol Research Faculty Publications

The prevalence of drugged driving has increased in the United States. Some drugged driving may be unintentional as prescription medications used as sleeping aids, like zolpidem, cause impairment after the predicted duration of therapeutic action has elapsed. The aim of this study was to determine if nighttime administration of alprazolam, a drug commonly prescribed off-label as a sleeping aid, impacts driving performance the following day. Participants were healthy adults (n = 15) who completed a double-blind, double-dummy, within-subjects inpatient study examining the effects of nighttime administration of alprazolam (0.5, 1, and 2 mg), zolpidem (10 mg), and placebo on driving …

A Qualitative Study Of End-Stage Liver Disease And Liver Transplant Referral Practices Among Primary Care Providers In Nonurban America, Vashisht Madabhushi, Matthew Wright, Gabriel Orozco, Allison Murphy, Antonio R. Garcia, Natalie D. Pope, Xiaonan Mei, Alexandra Cocca, Roberto Gedaly, Meera Gupta

Surgery Faculty Publications

Purpose: In rural America, the road to obtaining a liver transplant (LTX) often starts at the primary care provider’s (PCP’s) office. Patients with end-stage liver disease (ESLD) in rural communities experience lower rates of wait-listing and higher mortality. This study identifies issues related to the knowledge and perceptions of ESLD and LTX referral among PCPs in rural Kentucky (KY).

Methods: The study protocol involved relying upon a semistructured outline to explore the knowledge, attitude, and perceptions of PCPs toward ESLD and LTX referral among PCPs in rural KY. Inductive thematic analysis was utilized to identify, analyze, and report themes.

Findings: …