Redefining Recovery: Multimodal Analgesics And Tranexamic Acid In Orthopedic Surgery, Elijah Hoffman

Bone Bulletin

Introduction As the demand for joint replacements continues to rise, optimizing patient outcomes and enhancing recovery have become paramount goals for orthopedic surgeons. Patients used to have minimal mobility following a Total Knee Arthroplasty (TKA) or Total Hip Arthroplasty (THA) due to pain or the effects of sedation from anesthesia. This would lead to longer hospital stays, more complications, and higher opioid use.¹ These surgeries also resulted in levels of blood loss that required transfusion therapy postoperatively.² In recent years, there has been a paradigm shift in postoperative care for total joint arthroplasty (TJA), marked by significant advancements …

A Review Of The Effects Of Early Sport Specialization On The Health Of Adolescent Baseball Players, Robert C. Juniewicz

Bone Bulletin

Introduction

Participation in sports during adolescence is beneficial for participants as it improves fitness, enhances psychosocial development, increases academic performance, and boosts self-esteem.¹ One of the most popular sports among adolescent athletes is baseball, with nearly 500,000 high school players in the United States in 2020.1 While participation in sports has been shown to have clear benefits and has been steadily increasing, recent decades have also seen a dramatic rise in the level of competition.² As a direct result, there has been an increase in the prevalence of early sports specialization (ESS) with an estimated 14-47% of adolescent …

The Ins And Outs Of Wide-Awake Hand Surgery, Molly Milano

Bone Bulletin

Introduction

As the name might imply, “wide awake local anesthesia no tourniquet” (WALANT) is a surgical method to perform hand surgery using only a local anesthetic without the use of a tourniquet or any sedation and general anesthetics. The WALANT technique takes advantage of the vasoconstrictive effects of epinephrine combined with the local anesthetic effects of lidocaine to create a surgical field that does not require a tourniquet or general anesthesia.¹ The main contributor is epinephrine, which decreases bleeding in the surgical field while also lengthening lidocaine’s absorption and effect.² When first introduced to the surgical world, the …

Examining The Role Of Augmented Reality In Total Hip Arthroplasty, Joseph Raphael

Bone Bulletin

Background

In 2023, it was reported that total hip arthroplasty (THA) was the main and effective surgical treatment for advanced hip osteoarthritis, osteonecrosis, and rheumatoid arthritis.¹ As the population ages, the number of annual THA procedures is projected to grow and reach 635,000 by the year 2030.² As such, further improving outcomes in THA will benefit this large population. On average age for individuals who sustain a hip fracture is 80 years old and the lifetime prevalence of hip fractures is 20% in women and 10% in men.³ Fracture reduction and internal fixation or arthroplasty are often …

The Role Of Psychological Readiness In Recovery From Acl Injury In Female Athletes, Samantha Meacock

Bone Bulletin

The Anterior Cruciate Ligament (ACL) injury is common in sports, with female athletes facing a disproportionately higher risk in comparison to male athletes.¹ This susceptibility is the result of a complex relationship between various factors including anatomical, biomechanical, hormonal, neuromuscular, and environmental influences.² In addition, the unique challenges that females face with respect to sports, violence, body image, and family planning create additional stressors that may further contribute to an increased risk for injury.^3,4 Following ACL Reconstruction (ACLR) surgery, these gender discrepancies carry over into recovery as female athletes exhibit decreased rates of return to sport (RTS) …

Shoulder Arthroplasty In Patients With Inflammatory Arthritis: Preoperative And Perioperative Management Of Disease Modifying Anti-Rheumatic Drug Therapy, Daniel Kwak

Bone Bulletin

Introduction

Inflammatory arthritis is a debilitating systemic autoimmune and inflammatory disease that leads to joint damage, resulting in significant pain and disability. Rheumatoid arthritis (RA) is the most common inflammatory arthritis typically associated with advanced arthritic changes of the glenohumeral joint as well as with rotator cuff tears.²⁰ Since the introduction of disease modifying anti-rheumatic drug (DMARD) therapy, patients diagnosed with inflammatory rheumatic diseases have observed improvements in pain management and functional outcomes, alongside a reduction in the occurrence of upper limb arthroplasties.¹⁶ Nonetheless, total joint arthroplasty still remains common in the treatment of RA.^8,14

One recognized …

Revolutionizing Orthopaedics: Exploring The Therapeutic Potential Of Stem Cells, Harrison Fellheimer

Bone Bulletin

The development of stem cells holds the key to a revolutionary era in medicine, unlocking multisystem processes that will help restore normal function in the human body. Stem cells are undifferentiated cells that have the capability to give rise to cells of the same type, and from which new cells can arise through the process of differentiation. Several sources of stem cells can be broadly categorized into three main types: embryonic stem cells (ESC), adult stem cells, and induced pluripotent stem cells (iPSCs).¹

Exploring The Importance Of Implant Selection In Total Hip Arthroplasty, John Czarnecki

Bone Bulletin

Introduction

Total Hip Arthroplasty (THA) is a rapidly growing field within the United States. In 2023 alone, 1,050,821 arthroplasties were performed, making it the second-most performed arthroplasty of the year.1 With over a million of these procedures completed each year, there are several medical device companies that create their own implants to be used in these procedures. Each company can patent their own device and go through a thorough process involving the FDA to receive approval provided there is evidence from clinical trials that demonstrates their device improves patient outcomes.2 With the many implant options available, one question to consider …

A Spotlight On The Various Subspecialties Of Orthopedic Surgery, Ryan Garemani

Bone Bulletin

Introduction

Currently, 60% of orthopedic surgeons are specialists, 25% have specialty interests, and the remaining 15% are generalists.¹ Given the numbers, most orthopedists focus on a specific anatomical area or patient demographic, from delicate nerve work to the larger surgical field encountered in adult reconstruction. This article embarks on a journey through the diverse and impactful world of orthopedic subspecialties, shedding light on the breadth of practice offered.

According to Joseph A. Abboud, MD, a Rothman Orthopedics upper extremity surgeon, residents typically decide on a sub-specialty in their third or fourth year. For medical students, whether captivated by orthopedics …

Exploring Approaches To Treatment Of Musculoskeletal Injuries, Catherine Alvaro

Bone Bulletin

When approaching musculoskeletal injuries, there are many components of the patient assessment that contribute to different treatment options. Interviews with both an orthopedic surgeon and a sports medicine physician revealed similar yet different ways of diagnosing and treating orthopedic conditions.

Foreword, Alan S. Hilibrand

Bone Bulletin

As the Vice Chair of Academic Affairs and Faculty Development and as Director of Undergraduate Medical Education for the Department of Orthopaedic Surgery at the Sidney Kimmel Medical College, I am honored to once again have this opportunity to write a foreword for the second issue of the Bone Bulletin.

For many years, the DePalma Orthopaedic Society has provided medical students at SKMC with an excellent venue to learn about orthopaedic surgery, and its members continue to focus much time and energy on mentoring younger students interested in the field of orthopedic surgery. The DePalma leadership has worked hard …

Editors’ Note, Ari Clements, Amit Syal

Bone Bulletin

This year, we are very excited to announce the second issue of the Bone Bulletin, DePalma Orthopaedic Society’s student-run, non-peer reviewed journal for Sidney Kimmel Medical College (SKMC) students. The journal was initially started to provide another way to become involved with orthopaedics in medical school as well as providing a unique platform to report on diverse aspects of the field through editorial and opinion pieces.

By providing close 1-on-1 mentorship with a Rothman physician, the Bone Bulletin gives students a hands-on opportunity to engage with orthopaedic research and developments. Throughout this journal, you will find a variety of …

A Persuasive Case Against Government Authority In End-Of-Life Decisions For Vegetative Patients, Helen Gizachew

Helm's School of Government Conference - 2021-2024

The debate over whether the government should have jurisdiction to withdraw life support from people in a vegetative state is heating up, producing a persuasive case emphasizing the need to protect human liberty and oppose government overreach in matters of life and death. The key tenet of this argument is individual autonomy, which stresses a person's freedom to make decisions about their own life and body. Giving the government the authority to decide the fate of people in vegetative states violates this basic right, setting a dangerous precedent that undermines personal liberty and self-determination. Entrusting such decisions to a bureaucratic …

Confronting Cosmetic Carcinogens: A Proposal Regarding The Dangers Of Talcum Powder, Rachael Howell

Helm's School of Government Conference - 2021-2024

The Federal Government needs to stop the import, export, mining, and distribution of talcum powder in the United States. This is an issue that affects all Americans, especially active-duty military members.

Since 2013, there have been over 38,000 lawsuits against Johnson & Johnson, which allege that their talcum-based baby powder caused cancer. The plaintiffs in the very first talc case in the U.S. have died. All four of the plaintiffs from a 2019 suit have died. Yet, the 2019 case has been reversed and remanded. The FDA has redacted the names of scientist(s) that conduct “safety tests” on talc samples. …

Bilateral Eagle Syndrome: A Surprising Cause Of Neck Pain, Kailyn M. Mutsch, Alla Zamulko

Aesculapius Journal (Health Sciences & Medicine)

We report the case of a 45-year-old female who presented with chronic neck pain primarily left sided, globus sensation, and dysphagia for several years. Bilateral elongated styloid processes were identified on CT scan completed prior to the visit. Clinical and radiographic features were consistent with bilateral Eagle syndrome. Eagle syndrome can manifest as a constellation of symptoms characterized by throat and neck pain aggravated by rotation of the head, globus sensation of the throat, dysphagia, headache, tinnitus, syncope, or transient ischemic attacks in some cases. The objective of this case report was to discuss the features of Eagle syndrome and …

Investigating Vital Neutrophil Extracellular Trap Pathogen Response In Neutropenic Individuals, Ryan Illig

Thinking Matters Symposium

Neutrophils, also called polymorphonuclear leukocytes (PMNs), constitute the majority of innate immune cells. These cells possess a complex arsenal of functions that allow them to detect and eliminate a broad spectrum of pathogens. Neutropenia is characterized by decreased levels of neutrophils in the bloodstream, typically falling below the normal range. Moderate to severe neutropenia can increase the risk of pathogenic infections and without treatment can be life-threatening. Although the concentration of neutrophils in neutropenic individuals is decreased, upon activation, neutrophils still release neutrophil extracellular traps (NETs). NETs are pivotal in combating a spectrum of pathogens through their non-selective nature. Overreactive …

Geographic Distribution Of Melanoma Cases In Maine: Identifying Vulnerable Counties For Targeted Intervention, Joshua R. Parbs, Madeline Prentiss, Calla Hladky, Henry Stoddard, Kathryn Stevens, Elizabeth V. Seiverling, Peggy Cyr

Journal of Maine Medical Center

Introduction: Maine has the twelfth highest incidence of melanoma in the United States. The purpose of this study was to determine which Maine counties were the most impacted by melanoma through the use of geographical methods. Identification of counties with the highest prevalence of melanoma will help in targeting future training and public health interventions.

Methods: All melanoma cases (n=5,340) reported to the Maine CDC Cancer Registry from 2013 to 2018 were sorted by pathologic T stage. Data were sorted by county and population-adjusted. Population data and provider data came from Area Health Resource Files. County and zip-code maps were …

Helping Yourself To Help Others: Understanding The Impact Of Empathy On Providers In The Healthcare System, Eva Fabino '24

Social Work Student Scholarship

Eva Fabino ’24, Social Work and Psychology major
Faculty Mentor: Dr. Kathleen Kranz, Social Work

Psychedelic-Assisted Therapy: An Emerging Best Practice For Trauma Care?, Amelie Neubert '24

Social Work Student Scholarship

Amelie Neubert ’24, Social Work major
Faculty Mentor: Dr. Katherine Kranz, Social Work

Patient Advocate Experience: Combatting Language Barriers In Healthcare, Caroline Tourgee '24

Health Sciences Student Scholarship

Caroline Tourgee ’24, Health Policy and Management major

Navigating Child-Rearing With A Physical Disability: An Occupational Therapy Approach With Lived Experience, Randi M. Glisson

MOT Student Capstones

Parenting is a difficult occupation for anyone, but parenting with a physical disability presents additional challenges. Despite there being a similar rate of pregnancy for women with disabilities as non-disabled mothers, there is limited information available for parenting with a physical disability. The author theorized that by providing the needed educational resources on adaptive parenting, including the use of activity and environmental modifications and assistive technology, to parents with physical disabilities, knowledge of adaptive parenting would increase. This capstone incorporates a thorough literature review and is guided by the Model of Human Occupation and Human Activity Assistive Technology Model to …

The Effectiveness Of Dexmedetomidine As An Adjunct In Spinal Anesthesia For Pain Relief In Cesarean Patients: A Scoping Review, Tyler Polanco Bsn, Rn, William Riley Bsn, Rn, Michelle Russell Bsn, Rn, Christina Samson Bsn, Rn, Bria Sharp Bsn, Rn, Dwayne Accardo Dnp, Ccrna, Faana

Doctor of Nursing Practice Projects

No abstract provided.

Depression Screening In Type 2 Diabetes In Adolescent 12-18 Year Olds, Mykyla Coleman Bsn,Rn, Chelsea Conlee Bsn,Rn, Carol Gracia Msn, Aprn, Fnp-Bc, Emily Jennewine Msn, Aprn, Cpnp-Pc, Ibclc, Sally Humphrey Dnp, Aprn, Cpnp-Pc

Doctor of Nursing Practice Projects

Background

Although more commonly diagnosed in adults, type 2 diabetes is increasingly diagnosed in pediatric populations in the United States. Research suggests a correlation between depression and type 2 diabetes, however, a gap in research exists regarding depression and type 2 diabetes among pediatrics, specifically adolescents. This scoping review aims to address this gap by assessing the impact of depression screening on glycemic control in this specific population.

Purpose

The goal of the review is to contribute to the development of effective strategies for depressing screening in adolescents with type 2 diabetes, with the expectation this may positively impact glycemic …

Referral To In-Person Smoking Cessation Counseling As A Smoking Cessation Aid, Annie Mandrell Bsn, Rn, Matthew Keathley Bsn, Rn, Lewis Linden Bsn, Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Referral to In-Person Smoking Cessation Counseling as a Smoking Cessation Aid

Purpose/Background

Smoking increases an individual’s risk of acute and chronic disease morbidity and mortality, as well as creating a financial burden for the individual and healthcare system. In the United States, tobacco smoking is the leading cause of preventable death. There are an estimated 5 million tobacco-related deaths each year due to tobacco smoking. Additional healthcare costs are also seen due to the need for increased treatments, medical supplies, and staffing. Previous research for smoking cessation resources has primarily focused on traditional primary care offices. Research shows that in-person …

Real-World Use Of Bevacizumab For Treatment Of Advanced Ovarian Cancer Among Elderly Women In The U.S., Janet S. Hildebrand

MUSC Theses and Dissertations

Bevacizumab, a targeted VEGF inhibitor, is recommended for treatment of advanced ovarian cancer based on clinical trials demonstrating improved progression-free survival when added to standard chemotherapy. This study describes demographic, clinical and social factors, and outcomes associated with bevacizumab use among ovarian cancer patients in the US Medicare 5% sample. Kaplan-Meier curves and propensity score-weighted Cox proportional hazards models were used to estimate overall survival (OS) comparing bevacizumab to non-bevacizumab regimens. Of 3,760 patients with a principal diagnosis of ovarian cancer from 2016 to 2019, 1,508 had at least one observed line of chemotherapy; 457 had a second line following …

Mindful Education: Strategies For Promoting Body Positivity Through Literature Works In The Classroom, Ellie Kronberg

Honors Projects

This project presents a comprehensive guide with a structured, yet flexible framework for educators to adapt into their curriculums, and is aimed at assisting in facilitating meaningful discussions about body image and diversity through a study of literature. Using mentor texts, this guide provides educators with practical strategies and resources to promote positive body image in their classroom. These mentor texts have explicit themes of body representation, positivity, and self-acceptance, which emphasize the importance of promoting body diversity and challenging stereotypes. This guide offers insights into how literature can serve as a powerful tool for addressing body representation in a …

Collegiate Student-Athlete Mental Health In West Virginia: An Occupational Perspective, Natalie P. Gates, Bailey A. Riggs, Drew D. Altizer

Graduate Student Scholarship

Collegiate athletes must take on multiple roles while they are attending a college or university, which can negatively impact their mental health. These student-athletes must not only follow the role demands and expectations of an athlete but also of a college student, all while emerging into adulthood in the college environment. This can be overwhelming for many collegiate athletes, and they often find it difficult to balance all their responsibilities to live a satisfactory life. Therefore, a role for occupational therapy exists in this realm. A quantitative study design using survey methods was chosen in hopes of identifying and describing …

The Efficacy Of Implementing A Collaborative Palliative Pain Panel Team To Reduce Cancer Pain, Angela Lynette Embree

Doctoral Dissertations & Projects

Title of Manuscript: The Efficacy of Implementing a Collaborative Palliative Pain Panel Team to Reduce Cancer Pain Author name: Angela L. Embree Contributing author names: Dr. Nicole Harpold, Grand Valley State University, Dr. XXX XXX, XXX Palliative Care Clinic Key Words: cancer; pain; control; interprofessional care team; multidisciplinary care team; collaborative care Abstract Background: A palliative care clinic established a collaborative pain team to evaluate patients with severe, poorly controlled cancer-related pain. While the clinic collected data, it did not have a process for analyzing it and could not evaluate the effectiveness of this collaborative team. Objective: To evaluate the …

Increasing Social Inclusion And Engagement Of Exercise For Individuals With Spinal Cord Injuries: A Universal Resource Development For Wellness Facilities, Alexa Hall

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Individuals with spinal cord injuries (SCIs) are 1.5 times more likely to disengage in exercise one-year post-injury despite 80% of these individuals agreeing that exercise is critical to their overall health and quality of life (Baehr. Et al., 2022). A needs assessment was conducted on why the lack of engagement in exercise exists for individuals with SCIs within fitness facilities to identify barriers preventing participation. A quality improvement program called the Spinal Cord Injury Wellness Toolkit was created based off these findings and implemented at the MUSC Wellness Center. 14 individuals with SCIs participated at wellness center; REDCap surveys were …

Predicting Ffar4 Agonists Using Structure-Based Machine Learning Approach Based On Molecular Fingerprints, Zaid Anis Sherwani, Syeda Sumayya Tariq, Mamona Mushtaq, Ali Raza Siddiqui, Mohammad Nur-E-Alam, Aftab Ahmed, Zaheer Ul-Haq

Pharmacy Faculty Articles and Research

Free Fatty Acid Receptor 4 (FFAR4), a G-protein-coupled receptor, is responsible for triggering intracellular signaling pathways that regulate various physiological processes. FFAR4 agonists are associated with enhancing insulin release and mitigating the atherogenic, obesogenic, pro-carcinogenic, and pro-diabetogenic effects, normally associated with the free fatty acids bound to FFAR4. In this research, molecular structure-based machine-learning techniques were employed to evaluate compounds as potential agonists for FFAR4. Molecular structures were encoded into bit arrays, serving as molecular fingerprints, which were subsequently analyzed using the Bayesian network algorithm to identify patterns for screening the data. The shortlisted hits obtained via machine learning protocols …