Medicine and Health Sciences Commons^™

Patient Perceptions And Knowledge Of Corticosteroid Injections: A Cross-Sectional Survey Study, Juliet Chung, Sina Ramtin, Philip Koehler, Stephen Stache, Charles Langman, Bryan Hozack, Asif M. Ilyas

Rothman Institute Papers

INTRODUCTION: Although cortisone injections are commonly used, patient understanding of cortisone is variable and often affected by misconceptions. This study explores patient perspectives, identifies misconceptions, and emphasizes the importance of improved patient education to enhance patient-centered care.

METHODS: A cross-sectional survey study was conducted from April to August 2024 among patients aged 18 and older presenting to an orthopedic physicians' office. Patients completed a novel anonymous questionnaire designed to assess their knowledge and perceptions of cortisone injections. A total of 246 patients participated, with responses collected electronically via SurveyMonkey.

RESULTS: Among 246 respondents, individuals with history of prior cortisone infections …

The Agreement Between Pulse Oximetry And Measured Arterial Oxygen Saturations In Postoperative Functionally Univentricular Patients, Fabio Savorgnan, Sebastian Acosta, Joshua Prabhu, Pranathi Pilla, Vikram Shah, Saul Flores, Rohit S Loomba

Faculty, Staff and Students Publications

Background: Pulse oximetry is widely used to estimate arterial oxygen saturation, yet accuracy may vary for a number of reasons. Data on children with functionally univentricular circulation are limited. The primary aim of this study was to evaluate the agreement between arterial oxygen saturation measured by blood gas and pulse oximetry in children with functionally univentricular circulations. Methods: A retrospective analysis was performed of paired arterial blood gas and pulse oximetry oxygen saturation measurements following Norwood, Glenn, or Fontan procedures. Signed difference was defined as arterial oxygen saturation by blood gas-arterial oxygen saturation by pulse oximetry. Bland-Altman analyses, …

Impact Of Long-Term Nitrogen Scavenger Therapy On Clinical Outcome In Individuals With Urea Cycle Disorders, Roland Posset, Friederike Epp, Sven F Garbade, Florian Gleich, Andrea L Gropman, Sandesh C S Nagamani, Georg F Hoffmann, Stefan Kölker, Matthias Zielonka

Faculty, Staff and Students Publications

Principles of long-term medical management in individuals with urea cycle disorders (UCDs) encompass (1) a low protein diet, (2) supplementation of arginine and/or citrulline along with essential amino acids, nutrients, vitamins and trace elements, and (3) use of nitrogen scavenging agents to reduce recurrent hyperammonemic events (HAEs). These principles aim at providing metabolic stability, elimimation of chronic complications, and achievement of normal development as well as growth. A retrospective comparative analysis was performed by studying 138 individuals with male ornithine transcarbamylase deficiency (mOTC-D), citrullinemia type 1 (CTLN1) and argininosuccinic aciduria (ASA) based on in vitro residual enzymatic activity for severity-adjustment. …

“Real-World Prognostic Performance Of Different Severe And Advanced Heart Failure Definitions: Data From The Swedish Heart Failure Registry”, Federica Guidetti, Lars H Lund, Lina Benson, Camilla Hage, Felix Lindberg, Christian Basile, Alessandro Villaschi, Francesca Musella, Davide Stolfo, Raffaele Scorza, Guillame Baudry, Charlotta Ljungman, Oscar Braun, Valeria Valente, Biykem Bozkurt, Marco Metra, Gianluigi Savarese

Faculty, Staff and Students Publications

Background: A valid definition of severe heart failure (HF) is essential for earlier identification, timely referral for advanced therapies, and to optimize clinical trial design.

Objectives: To assess the prevalence, prognostic performance, and 1-year outcomes associated with different definitions of severe and advanced HF (AdvHF) in patients with heart failure with reduced ejection fraction (HFrEF).

Methods: We included 15,153 patients with EF < 40%, HF duration >6 months, and no prior left ventricular assist device or heart transplant, from the Swedish Heart Failure Registry. Several definitions of severe/AdvHF were evaluated: a simplified Heart Failure Association (HFA) definition (NYHA III-IV, EF < 30%, ≥2 HF hospitalizations in 12 months), the GALACTIC-Severe-definition (NYHA III-IV, EF < 30%, ≥1 hospitalization in 6 months), and variations adding/removing criteria such as NT-proBNP levels and diuretic dose to the HFA-AdvHF definition. Predictive performance and 1-year outcomes were analyzed.

Results: The HFA-definition identified …

Primary Vaginal Epithelioid Haemangioendothelioma With Pulmonary Metastasis: A Case Report And Review Of The Literature, Anwar Al Shuaili, Huda Kashoob, Zahida Niaz, Nausheen Yaqoob, Khadhra Ahmed J. Galaal, Reem Ahmed Al Mazrouai

Sultan Qaboos University Medical Journal

Epithelioid haemangioendothelioma (EHE) is a rare vascular sarcoma of intermediate malignancy. In 2023, a 31-year-old female presented to a tertiary care hospital in Muscat, Oman, with symptoms later diagnosed as primary vaginal EHE. The patient had primary, locally invasive vaginal EHE that subsequently metastasised to the lungs. The patient experienced progression of systemic disease despite chemotherapy and was therefore transitioned to palliative chemotherapy. The clinical, radiological and histopathological findings as well as the diagnostic features that distinguish EHE from its aggressive mimic, epithelioid angiosarcoma, are described in this report. This case highlights the diagnostic challenges, the importance of molecular confirmation …

Glucagon-Like Peptide 1 Receptor Agonist Discontinuation And Risks Of Major Adverse Cardiovascular Events In Adults With Type 2 Diabetes: Target Trial Emulation, Yan Xie, Taeyoung Choi, Ziyad Al-Aly

2020-Current year OA Pubs

OBJECTIVES: To characterise patterns of use of glucagon-like peptide 1 receptor agonists (GLP-1RAs) and assess the associations between various GLP-1RA treatment scenarios and the risk of major adverse cardiovascular events.

DESIGN: Target trial emulation.

SETTING: Electronic healthcare databases of US Department of Veterans Affairs, 1 January 2017 to 31 December 2023. Data obtained from domains in the Veterans Affairs Corporate Data Warehouse.

PARTICIPANTS: Veterans Affairs users with type 2 diabetes who started treatment with GLP-1RAs (n=132 551) or sulfonylureas (n=201 136), followed up for three years. Veterans Affairs users were defined as having at least two visits to Veterans Affairs …

The Level Of Physical Activity And The Feeling Of Stress In Difficult Life Situations Among Refugees From Ukraine, Bartosz Gondek, Iwona Bonisławska, Milena Lachowicz

Baltic Journal of Health and Physical Activity

Background: Russia's attack on Ukraine in February 2022 started the largest armed conflict in Europe since World War II. In the face of danger, crowds of civilians decided to leave their homes and escape, among others, to Poland in search of shelter. Materials and methods: The research was conducted on groups of refugees from Ukraine who registered in the first days of the war in Sopot and Pruszcz Gdanski. The refugees came from Kharkov, Mariupol, Kherson, Zaporizhzhia, and western Ukraine (not involved in hostilities). People from the war zone areas mostly came with only hand luggage. The respondents were divided …

Recurrent Pubic Osteomyelitis And Urosymphyseal Fistula In A Prostate Cancer Survivor: A Multidisciplinary Management Challenge, Peng Jhen Wu, Navin Sampathkumar, Tanmay Singh, Sonal Gandhi

Journal of Community Hospital Internal Medicine Perspectives

A 67-year-old male with a history of prostate cancer, treated with prostatectomy and subsequent radiation for recurrence, presented with a complex clinical course of recurrent osteomyelitis and a persistent urosymphyseal fistula with associated phlegmon. Following stereotactic body radiation therapy (SBRT) for a T4 vertebral lesion, he developed pelvic osteomyelitis, from which Kocuria species was cultured. The progression of his disease led to a urosymphyseal fistula, necessitating a cystectomy with ileal conduit and pubic bone debridement. Despite this extensive surgical intervention, he presented one year later with recurrent ileal conduit phlegmon and osteomyelitis. This case highlights the significant diagnostic and management …

An Unexpected Cause Of Thrombocytopenia In Pregnancy: A Case Of Malaria In A Non-Endemic Setting With Unclear Transmission Source, Jessica Ohemeng-Dapaah, Riham Mohammed, Ikechuwku Eke-Okoro

Journal of Community Hospital Internal Medicine Perspectives

Malaria remains a significant global health threat, with increasing concern for imported and locally acquired cases in non-endemic regions. We present the case of a 35-year-old pregnant woman from Sierra Leone, living in Missouri, who despite no recent international travel, was found to have symptomatic Plasmodium falciparum malaria. Her clinical course was notable for fever, severe thrombocytopenia, mild anemia and intraerythrocytic ring forms on her peripheral smear. She had a history of chronic hepatitis B and prior chemotherapy for Hodgkin lymphoma and recent travel to Florida, where local malaria transmission has been documented. The patient responded rapidly to artemisinin-based therapy, …

Cryptococcal And Ebv Meningitis In A Postpartum Woman With Hiv Despite Art: A Case Challenging The Limits Of Immune Reconstitution, Rouba Isshak, Zhaoqi Li, Aqsa Zoey Sorathia Md, Opeyemi Fakayode, Ivan Mercado, Malina Mohtadi, Nader Ghobriel, Mina Gerges, Patrick Michael, Simi Philip

Journal of Community Hospital Internal Medicine Perspectives

Cryptococcal meningitis (CM) is a life-threatening opportunistic infection, mainly affecting immunocompromised patients, especially with advanced HIV/AIDS. Unmasking cryptococcal immune reconstitution inflammatory syndrome (C-IRIS) is a severe but relatively rare complication in the United States. Co-infection with other central nervous system (CNS) pathogens further complicates both diagnosis and management.

In this case report, we present a rare instance of CM secondary to C-IRIS alongside EBV meningitis in a postpartum, HIV-positive patient on ART. This co-infection highlights the vulnerability of immunocompromised individuals, even on ART, to multifactorial CNS infections. It emphasizes the need for vigilant monitoring, timely intervention, and comprehensive long-term management …

When To Continue, Pause, Or Stop Sglt-2 Inhibitors In Heart Failure: A Complication-Based Clinical Guide, Nicole Tesoro, Jasvin Kurundrayil Manha, Sumanth Kumar Bandaru

Journal of Community Hospital Internal Medicine Perspectives

Sodium-glucose cotransporter 2 (SGLT2) inhibitors have become an essential part of guideline-directed medical therapy for heart failure due to their proven ability to reduce hospitalizations and improve survival, independent of diabetes status. Despite these benefits, their use can be complicated by genitourinary side effects such as genital mycotic infections, urinary tract infections, and, rarely, serious complications including urosepsis, Fournier’s gangrene, and euglycemic diabetic ketoacidosis. These events often leave clinicians uncertain about whether therapy should be continued, paused, or permanently discontinued. Current guidance remains limited and inconsistent, with most recommendations derived from case reports, expert opinion, or post-marketing surveillance. In this …

The Impact Of Social Determinants Of Health On Chronic Diseases: A Narrative Review, Farooq Hyder, Laraib Naeem Arain, Abdullah Ashraf, Abida Perveen, Hina Pervaiz

Journal of Community Hospital Internal Medicine Perspectives

Chronic diseases such as cardiovascular disease, diabetes, chronic respiratory disorders, and certain cancers are leading causes of morbidity and mortality worldwide. While biological and behavioral factors contribute to their development, growing evidence indicates that social determinants of health (SDOH) play a fundamental role in influencing chronic disease outcomes. SDOH include socioeconomic status, education, employment, housing conditions, neighborhood environment, access to nutritious food, and availability of healthcare services. These factors not only shape individual health behaviors but also determine access to preventive care, disease management resources, and overall quality of life. Individuals and communities facing socioeconomic disadvantage are disproportionately affected by …

Diagnosis And Characterization Of Thyroid Dysfunction In Patients Evaluated In Primary Care In A Rural Zone Of Honduras, Javier Shafick Asfura, Travis Wesley Harris, Amanda Reeck, María Fernanda Chévez

Journal of Community Hospital Internal Medicine Perspectives

Background: Thyroid disorders are prevalent and frequently underdiagnosed in primary care, particularly in resource-limited rural areas. Their nonspecific symptoms complicate early recognition and treatment. This study aimed to determine the prevalence of thyroid dysfunction and describe the clinical reasoning, diagnostic strategies, and laboratory findings among adults evaluated with TSH testing in rural Honduras. Methods: A retrospective, descriptive, cross-sectional study was conducted at Hospital Loma de Luz in Balfate, Honduras. Adult patients aged ≥18 years who underwent diagnostic TSH testing between January 1, 2022, and January 31, 2023, were included. Patients with prior thyroid diagnoses or current pregnancy were …

Food Insecurity’S Influence On Obesity, Hypertension, And Diabetes In Rural Vermont And Adirondack New York, Lindsay Morse

Walden Dissertations and Doctoral Studies

Food insecurity (FI) is a persistent public health challenge in the United States and disproportionately affects rural communities. Guided by syndemic theory, this quantitative cross-sectional study examined associations between FI and chronic disease outcomes among rural residents of Vermont and the Adirondack region of New York. Social determinants of health screenings and electronic medical records from 35 rural primary care sites were analyzed. Secondary data from n = 72,505 adults were used to evaluate these relationships. Binary logistic regression models assessed obesity, hypertension (HTN), and diabetes (DM), and a multinomial logistic regression model evaluated the combined presence of obesity and …

Polθ Activity Modulates Sensitivity To Standard Therapies In Dnmt3a-Deficient Leukemia, Bac Viet Le, Umeshkumar Vekariya, Monika M. Toma, Margaret Nieborowska-Skorska, Marie-Christine Caron, Malgorzata Gozdecka, Zayd Haydar, Martin Walsh, Jayashri Ghosh, Elaine Vaughan-Williams, Paulina Podszywalow-Bartnicka, Anna-Mariya Kukuyan, Sylwia Ziolkowska, Jessica Atkins, Emir Hadzijusufovic, Gurushankar Chandramouly, Reza Nejati, Katarzyna Piwocka, Richard T. Pomerantz, George S. Vassiliou, Brian J.P. Huntly, Peter Valent, Mariusz Wasik, Alfonso Bellacosa, Jean-Yves Masson, Gaorav P. Gupta, Grant A. Challen, Tomasz Skorski

Department of Biochemistry and Molecular Biology Faculty Papers

Myeloid malignancies carrying somatic DNMT3A mutations (DNMT3Amut) are refractory to standard therapy. DNMT3Amut leukemia cells accumulate toxic DNA double-strand breaks (DSBs) and stalled replication forks, rendering them dependent on DNA damage response (DDR). We report here that DNA polymerase theta (Polθ), a key element in DSB repair by end-joining (Polθ-mediated end-joining [TMEJ]) and in fork restarting, promotes survival and proliferation of DNMT3Amut leukemia cells. Polθ is overexpressed in DNMT3Amut leukemia cells due to abrogation of PARP1 PARylation-dependent UBE2O E3 ligase-mediated ubiquitination and proteasomal degradation of Polθ. In addition, PARP1-mediated recruitment of the SMARCAD1-MSH2/MSH3 repressive complex to DSBs is diminished in …

Redesigning Outpatient Chemotherapy Scheduling: A Management Approach To Site-Integrated Operations, Dominick J. Morrone

MUSC Theses and Dissertations

Outpatient infusion centers face persistent scheduling complexity driven by variable treatment durations, coordination between clinics, pharmacy lead times, and constrained staffing. This doctoral project develops and reviews a comprehensive framework for infusion scheduling transformation that integrates workforce role redesign, site‑level communication pathways, and data‑informed workqueue governance. Using a multi‑phase case at a large cancer center as an anchor, the framework specifies responsibilities across central schedulers, on‑site teams, medical coordinators, and nursing; details communication and escalation design (secure messaging and in‑basket use); and outlines training and proficiency tiers. The project synthesizes evidence from scheduling science and time-driven activity-based costing principles to …

2026 March 17 - Medical Student Education Committee Minutes, Medical Student Education Committee, East Tennessee State University

Medical Student Education Committee Minutes

No abstract provided.

Infectious Aortitis Secondary To Gastrointestinal Pathogens: A Case Series And Syndromic Review, Natasa Kostic, Ilana Goldberg, Devin Weber

Division of Internal Medicine Faculty Papers & Presentations

Aortitis is a rare but serious complication of infection that results in high morbidity and mortality. The most common location is in preexisting aneurysmal disease in a patient with multiple chronic comorbidities. The pathogens often reflect gastrointestinal bacteria, the classic example being Salmonella spp., but also include other enteric flora, Staphylococcus aureus, Streptococcus spp., and more. Herein, we describe 2 cases of aortitis caused by gastrointestinal bacteria and review management of this complex syndrome.

Genomic Medicine In Pediatrics: What Pediatricians Need To Know Now, Michael Smith, Scott T. Younger

Pediatrics in Practice: A CME Podcast

Genomic medicine is playing an increasingly important role in pediatric care, but it can feel complex for general pediatricians. In this episode of Pediatrics in Practice, Scott Younger, PhD, discusses how genomics is already influencing pediatric diagnosis and care today, common scenarios where genetic insights may be helpful, and why genomic testing can be valuable even when it doesn’t lead to a targeted therapy. This conversation offers practical guidance on when to consider genomics, when to refer, and how pediatricians can partner with genetics and subspecialty teams to support patients and families.

Click here to stream the podcast episode.

Impact Of Depression And Anxiety On Outcomes Following Muscle-Preserving Transforaminal Lumbar Interbody And Fusion., Sahil Garg, Sean M Muir, Kyle Jamar, Alexa Dietrich, Patrick Young, Sonny Gill

Surgery Articles

Background: The impact of concurrent diagnoses of anxiety and depression has not been extensively studied in spine surgery. We hypothesize that a muscle-sparing technique may be associated with decreased postoperative pain and improved strength postoperatively compared to open techniques, decreasing the stress of the postoperative recovery process. Therefore, this study aims to assess the benefits that a modified muscle-preserving lumbar fusion technique (Wiltse transforaminal lumbar interbody and fusion (W-TLIF)) would have on this subset of patients.

Methods: One hundred twenty subjects who underwent a single-level W-TLIF were identified with a recorded diagnosis status associated with mental health. The subjects underwent …

Living In Liberal Areas Reduced Covid-19 Vaccine Hesitancy Among Conservatives, Brittany L. Kmush, Rachel E. Dinero

Population Health Research Brief Series

Political divisions shaped public health responses throughout the COVID-19 pandemic, with conservatives expressing higher vaccine hesitancy than liberals. But does where conservatives live matter? This brief summarizes findings from a study using survey data from 683 U.S. adults (ages 18-94) collected March-April 2023, combined with 2020 presidential election results by zip code. The authors found that liberals consistently had low vaccine hesitancy and high uptake regardless of where they lived, but conservatives living in lower Trump vote share communities reported lower vaccine hesitancy and higher vaccination and booster uptake than conservatives in high Trump vote share communities. This pattern was …

Remote Language Assessment In School-Age Children With Phelan–Mcdermid Syndrome And Genotype–Phenotype Correlation, Sarah Quadri-Valverde, Jessica Klusek Ph.D., Ccc-Slp, Linda D. Ward, Diana Ivankovic, Nancy Powers, Vijay Shankar, Rachel A. Lyman, Trudy F.C. Mackay, William Bridges, Katy Phelan, Chris Rogers, Luigi Boccuto, Sara M. Sarasua

Faculty Publications

People with Phelan–McDermid syndrome (PMS) have reduced speech and language abilities, yet little research has profiled the communication abilities in this population. The purpose of this study was threefold: identifying the language and communication profiles of school-aged children with PMS, identifying genetic contributions to language and communication abilities, and determining the feasibility of remote data collection for research purposes. A speech language pathologist used standardized assessments and direct evaluations by video conferencing to evaluate language and communication abilities. Sixteen children and adolescents were evaluated: 5 with SHANK3 pathogenic variants, 9 with 22q13 deletions including SHANK3 (PMS-SHANK3 related), and 2 …

Assessing Misidentification Potential When Using Percent Developmental Delay As An Early Intervention Eligibility Criterion, Allison Gladfelter, Sarah Thomas, Christine Nguyen, Sarah O'Connor

CISLL Publications

Purpose:

Method:

03-17-26 Bor Hsc Committee Meeting Agenda, Patricia Serna

HSC Committee (A subcommittee of the UNM Board of Regents)

03-17-26 BOR HSC Committee Meeting Agenda

Whole-Blood, Concentrated, And Micro–Dose Del Nido Cardioplegia In Adult Cardiac Surgery: A Scoping Review, Christian Iulianelli

Student Works

1. A.     Background/Introduction: Del Nido cardioplegia was originally developed for pediatric cardiac surgery to provide prolonged myocardial protection with a single-dose strategy. Its adoption in adult cardiac surgery has led to multiple modified formulations, including whole-blood, concentrated, and bloodless strategies. Given expanding clinical use and variation in technique, a structured mapping of the adult evidence base is warranted.
2. B.     Methodology: This scoping review followed PRISMA-ScR guidance. PubMed and CINAHL were searched, yielding 88 records. After duplicate removal and screening, 18 studies met inclusion criteria. Data were charted on study design, cardioplegia formulation, patient population, myocardial biomarkers, arrhythmias, renal outcomes, transfusion requirements, …

Development And Validation Of The Emergency Department Transitions Measure, Sara Beachy, Danielle M. Mccarthy, Julianna Lenoir, Alexzandra Gentsch, Richard W. Hass, Marissa Witmer, Paula Ostroff, Melissa Tupas, Lindsey Shughart, Hailey Shughart, Kristin L. Rising

Jefferson Center for Connected Care Faculty Papers

BACKGROUND: Transitions of care are high-risk periods for patient safety in the emergency department (ED), particularly for patients who are still in the diagnostic process and are discharged with diagnostic uncertainty. Care transitions must be improved for these patients, as one third of discharged ED patients have diagnostic uncertainty. Yet there are no validated measures that assess the quality of care transitions from the ED, limiting the ability to assess the impact of interventions. Thus, we developed and validated the ED Transitions (EDT) measure.

METHODS: This mixed methods study was conducted across a large healthcare system in three phases: item …

Efficacy And Safety Of Approved Cellular Therapies And Bispecific Antibodies In Solid Tumors: The Current State, Rabab Zehra Jafry, Saba Bilal Qamar, Sohaib Irfan, Muhammad Abbas Abid, Virginia Mohlere, Neha Maithel, Syed Hassan Jafri, Sanjay Awasthi, Samer Srour, Irfan A Vaziri, Muhammad Bilal Abid

Faculty, Staff and Student Publications

Cancer immunotherapy is a broad term including naked antibodies, bispecific antibodies (BsAbs), immune-checkpoint inhibitors (ICIs), chimeric antigen receptor T-cell (CAR-T) therapy, cancer vaccines, activated immune cells, and allogeneic hematopoietic cell transplantation. Recent advances in immune-engaging T-cell therapies have led to significant progress in novel treatments across various cancer types, resulting in prolonged patient survival, mainly in patients with hematologic malignancies. Several CAR T-cell constructs and BsAbs have been approved by regulatory authorities worldwide for relapsed, refractory leukemia, non-Hodgkin lymphoma, and multiple myeloma. Solid tumors are characterized by an immunosuppressive, fibroinflammatory tumor microenvironment (TME) and immune-suppressive cells, such as regulatory T-cells …

Fungal Meningitis In Us Patients Who Received Epidural Anesthesia In Matamoros, Mexico, Dallas J Smith, Elizabeth Misas, Jeremy A W Gold, Nicole Evert, Thi Dang, Emilie Prot, Simone Godwin, Julieanna Rivas, Jessica Pearson, Lori Koenecke, Nirma D Bustamante, Maria Julia Marinissen, Gabriel Garcia Rodriquez, Irma López-Martínez, Caitlyn Lutfy, Samantha Williams, Axel A Vazquez Deida, Katrina M Byrd, Julian A Villalba, Sarah Reagan-Steiner, Lindsay Parnell, Lalitha Gade, Romney M Humphries, Nathan P Wiederhold, Charles Y Chiu, Joshua A Lieberman, Anastasia P Litvintseva, Tom Chiller, Luis Ostrosky-Zeichner, Fungal Meningitis Response Team

Faculty, Staff and Student Publications

Background: Fungal meningitis outbreaks are rare and entail high mortality rates. Beginning May 2023, we investigated fungal meningitis caused by Fusarium solani species complex occurring in US patients who received epidural anesthesia in Matamoros, Mexico.

Methods: Early epidemiological information suggested US patients with suspected fungal meningitis had undergone mostly cosmetic procedures under epidural anesthesia performed in 2 Matamoros clinics. US patients known to have received surgery at these clinics during 1 January-13 May 2023 (clinic closures date) were identified and notified by public health officials. Epidemiological and clinical data were used to update diagnostic and clinical guidance for outbreak response, …

A Tibial Osteotomy Of The Medial Collateral Ligament Insertion To Improve Visualization Of The Medial Tibial Plateau: A Cadaveric Study, Kathryn A Barth, Ricardo R Tijerina, Adeet Amin, Avrey A Novak, Erik N Mayer, Sabir K Ismaily, John W Munz, Andrew M Choo, Timothy S Achor, Steven J Warner, Jonathan G Eastman, Patrick J Kellam

Faculty, Staff and Student Publications

Objectives: To compare visualization of the medial tibial plateau articular surface using three surgical approaches: medial collateral ligament (MCL) split, femoral epicondyle osteotomy of the MCL origin, and tibial osteotomy of the MCL insertion.

Methods: Seven matched pairs of fresh-frozen adult cadaveric lower extremity specimens (14 knee specimens total) with no evidence of previous surgery were utilized. Through a medial approach to the proximal tibia, the MCL split technique was performed followed by a sub-meniscal arthrotomy. Standardized distraction of the joint was applied using a universal distractor. A three-dimensional digitizer probe was utilized to map the visible articular surface. These …

2026 Clinical Practice Guideline Update By The Infectious Diseases Society Of America And The Pediatric Infectious Diseases Society On The Management Of Community-Acquired Pneumonia In Infants And Children Older Than 3 Months Of Age: The Use Of Tpa And Dnase Or Tpa Alone For Fibrinolysis, Shawn D St Peter, Krow Ampofo, Thomas Brogan, Michael D Cabana, Claudia Espinosa, Todd A Florin, Jeffrey S Gerber, Michelle Gill, Debra L Palazzi, Mark Sawyer, Angela M Statile, Derek J Williams, Sheena Patel, Mark I Neuman, Samir S Shah

Faculty, Staff and Students Publications

This paper is part of a larger clinical practice guideline on the diagnosis and management of parapneumonic effusion and empyema in children, developed by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. In this report, the panel provides recommendations for intrapleural fibrinolysis with tissue plasminogen activator (tPA) alone over tPA and dornase alfa (DNase) in children (3 months to 18 years) with complicated parapneumonic effusion and empyema. The panel's recommendations are based upon evidence derived from systematic literature reviews and adhere to a standardized methodology for rating the certainty of evidence and strength of recommendation according …