Wounds and Injuries Commons^™

An Evidence-Based Bundle To Decrease Pressure Injuries (Pis) In Homecare, Esther Owookade

Student Scholarly Projects

Practice Problem: Pressure injuries are a significant problem in healthcare settings. The older adult patients in this home health agency have experienced an increased in incidences of pressure injuries which necessitates intervention.

PICOT: The PICOT question that guided this project was" In older adults 65years and above with pressure injuries in the home healthcare setting(P), does a pressure injury care bundle(I), compared to the current practices of standard care of repositioning alone( C),reduce the incidence of pressure injuries( O ) in 10 weeks (T)?"

Evidence: The evidence used to guide this evidence-based change project was from relevant health …

Nanoparticle-Based Approaches To Brain Injury And Studies For Improved Detectability Toward Better Delivery Characterization, Hunter A. Miller

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

The clinical translation of nanoparticle (NP) therapeutics for brain injury has been slow despite preclinical promise. The causes of disconnect between preclinical and clinical outcomes is multifactorial, but insufficient delivery is noteworthy. Preclinical delivery characterization often lacks, obscuring mechanisms of failure, slowing development. Multimodal imaging is a promising strategy to improve delivery characterization, combining the strengths of various modalities. Magnetic resonance imaging (MRI) and luminescence imaging are a suitable combination for multimodal imaging, expanding the spatial and temporal resolution of either alone, but further material development is needed to enhance detectability. One problem is the interference of cellular autofluorescence in …

Epidural Stimulation For Urogenital Dysfunction In The Spinal Cord Injured Rat., Natasha Lorraine Wilkins

Electronic Theses and Dissertations

Spinal cord injury (SCI) is a devastating, life changing event that greatly impacts quality of life. SCI can have body-wide, multi-system consequences including dysfunction within the urogenital system. Challenges with the urinary system include urinary incontinence, urine retention, and detrusor-sphincter dyssynergia all of which require maintenance through the regular use of catheters. Sexual dysfunction in men, who comprise nearly 80% of the SCI population, includes erectile dysfunction, anejaculation, retrograde ejaculation, poor expulsive force during ejaculation, and poor sperm quality. The treatment for sexual function in SCI men is focused more on fertility through the collection of sperm for insemination procedures …

Evaluation Of Myogenic Differentiation Potential Of Bmd Ipscs In Vitro And The Effect Of Ubiquitination Inhibitors On Dystrophin Stability In Vivo, Muchen Liu

Dissertations and Theses (Open Access)

Background: Muscular dystrophies are heterogeneous groups of inherited diseases leading to progressive muscular weakness and degeneration. In the case of Becker muscular dystrophy (BMD), non-disrupting mutations of the DMD gene reading frame is the causative defect. By the age of 30s, about 60 to 70% of BMD patients develop cardiomyopathy, which is often lethal. Unfortunately, there is currently no cure for BMD. Meanwhile, improvement of dystrophin stability by repressing polyubiquitination is a promising strategy. The application of human iPSCs in tissue regeneration also serves as a potential therapeutic strategy. This study aims to test the efficacy of selected drugs interfering …

Co-Localization Of Osteoclasts Differentiation Markers In An Implant Model In Diabetic Mice, Diego Adobbati, Deborah Rocha Seixas, Danieli Rodrigues, Claudia C. Biguetti

School of Podiatric Medicine - Student Research

Introduction and Hypothesis: Diabetes can impair implant osseointegration and impact implant functionality. While significant research has focused on osteogenesis during the osseointegration, little attention has been given to pre-osteoclast differentiation. We hypothesize that diabetes increases pre-osteoclast activity potentially leading to implant failure. This study aims to identify and localize osteoclast markers, specifically DC-STAMP (Dendritic Cell-Specific Transmembrane Protein) and NFATc2 (Nuclear Factor of Activated T-cells, cytoplasmic 2), in diabetic (D) and non-diabetic (ND) mice.

Methodology: Twenty-four 16-week-old male 129 Sv mice (12 diabetic and 12 non-diabetic) underwent implantation with a 0.5x1.5 mm commercially pure titanium screw in the right maxillary bone. …

Splenic Artery Embolization In The Treatment Of Blunt Splenic Injury: Single Level 1 Trauma Center Experience, Katelyn Gill, Sarah Aleman, Alexandra H. Fairchild, Bahri Üstünsöz, Dan Laney, Alison A. Smith, Hector Ferral

School of Medicine Faculty Publications

PURPOSE: To describe the experience of a single level 1 trauma center in the management of blunt splenic injuries (BSI). METHODS: This is a retrospective study with Institutional Review Board approval. The medical records of 450 patients with BSI treated between January 2016 and December 2022 were reviewed. Seventy-two patients were treated with splenic artery embolization (SAE), met the study criteria, and were eligible for data analysis. Spleen injuries were graded in accordance with the American Association for the Surgery of Trauma Organ Injury Scale. Univariate data analysis was performed, with P < 0.05 considered statistically significant. RESULTS: The splenic salvage rate was 90.3% (n = 65/72). Baseline demographics were similar between the groups (P > 0.05). Distal embolization with Gelfoam had similar rates …

Cutaneous Wound Healing And The Effects Of Cannabidiol, Pearl Shah, Kathryne Holmes, Fairouz Chibane, Phillip Wang, Pablo Chagas, Evila Salles, Melanie Jones, Patrick Palines, Mohamad Masoumy, Babak Baban, Jack Yu

School of Medicine Faculty Publications

Cutaneous wounds, both acute and chronic, begin with loss of the integrity, and thus barrier function, of the skin. Surgery and trauma produce acute wounds. There are 22 million surgical procedures per year in the United States alone, based on data from the American College of Surgeons, resulting in a prevalence of 6.67%. Acute traumatic wounds requiring repair total 8 million per year, 2.42% or 24.2 per 1000. The cost of wound care is increasing; it approached USD 100 billion for just Medicare in 2018. This burden for wound care will continue to rise with population aging, the increase in …

Mhealth-Based Just-In-Time Adaptive Intervention To Improve The Physical Activity Levels Of Individuals With Spinal Cord Injury: Protocol For A Randomized Controlled Trial, Rachel Carey, Ha Le, Donna Coffman, Inbal Nahum-Shani, Mohanraj Thirumalai, Cole Hagen, Laura Baehr, M. Schmidt-Read, Marlyn Lamboy, Stephanie A Kolakowsky-Hayner, Ralph Marino, Stephen Intille, Shivayogi Hiremath

Moss-Magee Rehabilitation Papers

BACKGROUND: The lack of regular physical activity (PA) in individuals with spinal cord injury (SCI) in the United States is an ongoing health crisis. Regular PA and exercise-based interventions have been linked with improved outcomes and healthier lifestyles among those with SCI. Providing people with an accurate estimate of their everyday PA level can promote PA. Furthermore, PA tracking can be combined with mobile health technology such as smartphones and smartwatches to provide a just-in-time adaptive intervention (JITAI) for individuals with SCI as they go about everyday life. A JITAI can prompt an individual to set a PA goal or …

Recurrent Upper Gastrointestinal Bleeding Due To Radiation-Induced Hemorrhagic Gastroduodenal Ectasia: A Review Of Current Treatment Options For Radiation-Induced Gastric Injury, Simone Jarrett, Rushi Kaushik Talati, Johann Hasbun, Wenqing Cao, Scott Smukalla

Einstein Health Papers

INTRODUCTION: Acute upper gastrointestinal bleeding is one of the most common medical emergencies that present to the hospital, and delineating the underlying etiology is essential to provide adequate definitive treatment. The purpose of this case report was to review the diagnosis and treatment of a rare complication known as radiation-induced hemorrhagic gastritis (RIHG) that can occur in patients with prior radiation exposure. The motivation for this study arose from the identification of a case within our institution.

CASE PRESENTATION: The study involved a review of the diagnosis and management of a patient who presented with anemia and recurrent episodes of …

Towards A Remote Patient Monitoring Platform For Comprehensive Risk Evaluations For People With Diabetic Foot Ulcers, Gozde Cay, M G Finco, Jason Garcia, Jill L Mcnitt-Gray, David G Armstrong, Bijan Najafi

Center on Aging Staff Publications

Diabetic foot ulcers (DFUs) significantly affect the lives of patients and increase the risk of hospital stays and amputation. We suggest a remote monitoring platform for better DFU care. This system uses digital health metrics (scaled from 0 to 10, where higher scores indicate a greater risk of slow healing) to provide a comprehensive overview through a visual interface. The platform features smart offloading devices that capture behavioral metrics such as offloading adherence, daily steps, and cadence. Coupled with remotely measurable frailty and phenotypic metrics, it offers an in-depth patient profile. Additional demographic data, characteristics of the wound, and clinical …

Autologous Bone Marrow Mononuclear Cells To Treat Severe Traumatic Brain Injury In Children, Charles S Cox, David M Notrica, Jenifer Juranek, Jeffrey H Miller, Fabio Triolo, Steven Kosmach, Sean I Savitz, P David Adelson, Claudia Pedroza, Scott D Olson, Michael C Scott, Akshita Kumar, Benjamin M Aertker, Henry W Caplan, Margaret L Jackson, Brijesh S Gill, Robert A Hetz, Michael S Lavoie, Linda Ewing-Cobbs

Faculty, Staff and Student Publications

Autologous bone marrow mononuclear cells (BMMNCs) infused after severe traumatic brain injury have shown promise for treating the injury. We evaluated their impact in children, particularly their hypothesized ability to preserve the blood–brain barrier and diminish neuroinflammation, leading to structural CNS preservation with improved outcomes.

We performed a randomized, double-blind, placebo-sham-controlled Bayesian dose-escalation clinical trial at two children's hospitals in Houston, TX and Phoenix, AZ, USA (NCT01851083). Patients 5–17 years of age with severe traumatic brain injury (Glasgow Coma Scale score ≤ 8) were randomized to BMMNC or placebo (3:2). Bone marrow harvest, cell isolation and infusion were …

Comparing The Effectiveness Of Hyaluronic Acid And Dextrose Prolotherapy Injections In The Treatment Of Lateral Epicondylitis: A Systematic Review And Meta-Analysis, Sara Ragab, Sami Dakhel, Jonathan Elias, Hesham Abdelfattah

Rowan-Virtua Research Day

Background: Lateral epicondylitis (LE), commonly referred to as tennis elbow, is characterized by micro-tears to the tendon origin that attaches to the outer portion of the elbow, with the extensor carpi radialis brevis being the most commonly affected tendon. It presents most often amongst manual workers and athletes that participate in repetitive movements. Patients may experience burning and aching sensations that can potentially radiate down to the wrist. Hyaluronic acid is a primary component of synovial fluid and has anti-inflammatory properties and also provides lubrication to joints. Prolotherapy involves injection of an irritant, most commonly dextrose, into the common extensor …

The Sexual Trauma Of The Female Body: Violence Against Women In Contemporary Spanish And Latin American Cultures, Lara Armenteros Garrido

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

This dissertation focuses on the idea that women’s bodies have a sexual stigma attached to them as a consequence of different forms of heteropatriarcal violence inflicted on them. From violence in public spaces, such as street harassment or the sexual exploitation of women, to the intimacy of the relationship, like intimate partner violence or the orgasm gap, it becomes increasingly difficult for women to escape violence. Through the analysis of films, documentaries, narratives, and the testimonies of women from Spain and Latin America, I argue there is still a lack of adequate sexual and emotional knowledge to help complete agency …

Probability Of Occult Ankle Fracture Based On Radiograph-Measured Swelling, Christian Kenneth Kerut, Srikanth Mudiganty, Denise Goodfellow Kerut, Ronald L. Horswell, Reagan Williams, Melanie Valencia, Joseph Gonzales

School of Medicine Faculty Publications

INTRODUCTION: Pediatric ankle injuries are a common presentation in the emergency department (ED). A quarter of pediatric ankle fractures show no radiographic evidence of a fracture. Physicians often correlate non-weight bearing and tenderness with an occult fracture. We present this study to predict the probability of an occult fracture using radiographic soft-tissue swelling on initial ED radiographs. METHODS: This is a retrospective study at a Level 1 pediatric trauma center from 2021 to 22. Soft-tissue swelling between the lateral malleolus and skin was measured on radiographs, and weight-bearing status was documented. Statistical analysis was conducted using Stata software. DISCUSSION: The …

Five-Year Mortality Rates Following Elective Shoulder Arthroplasty And Shoulder Arthroplasty For Fracture In Patients Over Age 65., Adam Khan, Xiaoran Zhang, Erlyn Macarayan, Matthew Best, Catherine Fedorka, Derek Haas, April Armstrong, Andrew Jawa, Evan O'Donnell, Jason Simon, Eric Wagner, Momin Malik, Michael Gottschalk, Gary Updegrove, Jon Warner, Uma Srikumaran, Joseph Abboud

Rothman Institute Papers

BACKGROUND: To effectively counsel patients prior to shoulder arthroplasty, surgeons should understand the overall life trajectory and life expectancy of patients in the context of the patient's shoulder pathology and medical comorbidities. Such an understanding can influence both operative and nonoperative decision-making and implant choices. This study evaluated 5-year mortality following shoulder arthroplasty in patients ≥65 years old and identified associated risk factors.

METHODS: We utilized Centers for Medicare & Medicaid Services Fee-for-Service inpatient and outpatient claims data to investigate the 5-year mortality rate following shoulder arthroplasty procedures performed from 2014 to 2016. The impact of patient demographics, including fracture …

A Novel Sequential Compression Appliance To Reduce Scarring Of The Face, Michelle N. Dwertman, Henry B. Huson

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, ABA 2024; April 9 - 12, 2024, Chicago, IL

The Stress Of Measuring Plantar Tissue Stress In People With Diabetes-Related Foot Ulcers: Biomechanical And Feasibility Findings From Two Prospective Cohort Studies, Chantal M Hulshof, Madelyn Page, Sjef G Van Baal, Sicco A Bus, Malindu E Fernando, Lisette Van Gemert-Pijnen, Kilian D R Kappert, Scott Lucadou-Wells, Bijan Najafi, Jaap J Van Netten, Peter A Lazzarini

Center on Aging Staff Publications

Reducing high mechanical stress is imperative to heal diabetes-related foot ulcers. We explored the association of cumulative plantar tissue stress (CPTS) and plantar foot ulcer healing, and the feasibility of measuring CPTS, in two prospective cohort studies (Australia (AU) and The Netherlands (NL)). Both studies used multiple sensors to measure factors to determine CPTS: plantar pressures, weight-bearing activities, and adherence to offloading treatments, with thermal stress response also measured to estimate shear stress in the AU-study. The primary outcome was ulcer healing at 12 weeks. Twenty-five participants were recruited: 13 in the AU-study and 12 in the NL-study. CPTS data …

Aortic Stenosis Management In Patients With Acute Hip Fracture, Juan A. Terré, Juan Torrado, Isaac George, Rafael Harari, Pedro R. Cox-Alomar, Pedro A. Villablanca, Robert T. Faillace, Juan F. Granada, George Dangas, Mario J. Garcia, Azeem Latib, José Wiley

School of Medicine Faculty Publications

The treatment of severe aortic stenosis (SAS) has evolved rapidly with the advent of minimally invasive structural heart interventions. Transcatheter aortic valve replacement has allowed patients to undergo definitive SAS treatment achieving faster recovery rates compared to valve surgery. Not infrequently, patients are admitted/diagnosed with SAS after a fall associated with a hip fracture (HFx). While urgent orthopedic surgery is key to reduce disability and mortality, untreated SAS increases the perioperative risk and precludes physical recovery. There is no consensus on what the best strategy is either hip correction under hemodynamic monitoring followed by valve replacement or preoperative balloon aortic …

Does An Early, Balanced Resuscitation Strategy Reduce The Incidence Of Hypofibrinogenemia In Hemorrhagic Shock?, David T Lubkin, Krislynn M Mueck, Gabrielle E Hatton, Jason B Brill, Mariela Sandoval, Jessica C Cardenas, Charles E Wade, Bryan A Cotton

Faculty, Staff and Student Publications

OBJECTIVES: Some centers have recommended including concentrated fibrinogen replacement in massive transfusion protocols (MTPs). Given our center's policy of aggressive early balanced resuscitation (1:1:1), beginning prehospital, we hypothesized that our rates of hypofibrinogenemia may be lower than those previously reported.

METHODS: In this retrospective cohort study, patients presenting to our trauma center November 2017 to April 2021 were reviewed. Patients were defined as hypofibrinogenemic (HYPOFIB) if admission fibrinogen

RESULTS: Of 29 782 patients, 6618 level 1 activations, and 1948 patients receiving emergency release blood,

CONCLUSIONS: Low rates of hypofibrinogenemia were found in our center which treats hemorrhage with early, balanced …

Clinical Efficacy Of Blood Derivatives On Wound Healing: A Systematic Review And Network Meta-Analysis, Yanhong Wu, Guang Peng, Yuzhi Wang, Jianwu Chen, Bin Zhang, Jianbing Tang, Biao Cheng

Faculty, Staff and Student Publications

This study aims to evaluate the clinical effects of different blood derivatives on wound healing using network meta-analysis. PubMed, Embase, OVID, Web of Science, SCOPUS and Cochrane Central were searched to obtain studies about blood derivatives on wound healing until October 2023. R 4.2.0 and Stata 15.0 softwares were used for data analysis. Forty-four studies comprising 5164 patients were included. The results of network meta-analysis showed that the healing area from high to low was GF + ORCCB, ORCCB, GF, PRF, Unnas paste dressing, APG, PRP injection, PRP, PRP + thrombin gel, PPP, HPL, CT. The healing time from low …

Oxidized Activated Charcoal Nanozymes: Synthesis, And Optimization For In Vitro And In Vivo Bioactivity For Traumatic Brain Injury, Emily A Mchugh, Anton V Liopo, Kimberly Mendoza, Claudia S Robertson, Gang Wu, Zhe Wang, Weiyin Chen, Jacob L Beckham, Paul J Derry, Thomas A Kent, James M Tour

Faculty, Staff and Student Publications

Carbon-based superoxide dismutase (SOD) mimetic nanozymes have recently been employed as promising antioxidant nanotherapeutics due to their distinct properties. The structural features responsible for the efficacy of these nanomaterials as antioxidants are, however, poorly understood. Here, the process-structure-property-performance properties of coconut-derived oxidized activated charcoal (cOAC) nano-SOD mimetics are studied by analyzing how modifications to the nanomaterial's synthesis impact the size, as well as the elemental and electrochemical properties of the particles. These properties are then correlated to the in vitro antioxidant bioactivity of poly(ethylene glycol)-functionalized cOACs (PEG-cOAC). Chemical oxidative treatment methods that afford smaller, more homogeneous cOAC nanoparticles with higher …

Risk Factors For Non-Healing Wounds—A Single-Centre Study, Daniel Wolny, Ladislav Štěpánek, Dagmar Horáková, Janet Thomas, Jana Zapletalová, Mihir Sanjay Patel

Faculty, Staff and Student Publications

Background: Chronic wounds present a significant clinical, social, and economic challenge. This study aimed to objectify the risk factors of healing outcomes and the duration of chronic wounds from various etiologies. Methods: Patients treated for non-healing wounds at the surgical outpatient clinic of the Olomouc Military Hospital were involved. Data from patients treated between 8/2021 and 9/2023 were selected. Patients were mostly treated as outpatients, with microbiological follow-up indicated in cases of advanced signs of inflammation. Results: There were 149 patients who met our selection criteria (the mean age was 64.4 years). Predominant causes of wounds involved diabetes (30.9%), post-trauma …

Burden Of Dog Bite Injuries And Wound Management Practices To Prevent Rabies Among Dog Owners, Dhawani Julka, Amir M Khan, Nitu Kumari, Ujjwal Soni

Faculty, Staff and Student Publications

BACKGROUND: Despite members of dog-owning families being at a higher risk of dog bites owing to their proximity to dogs in their household, there are hardly any studies from India which focus on the burden of dog bites among them and their rabies control and prevention practices. This study aimed to estimate the burden of dog bites among dog owners and their wound management practices to prevent rabies.

MATERIALS AND METHODS: A cross-sectional study was conducted among pet dog owners in a high-end housing society of National Capital Region of Delhi. A pre-tested and pre-validated schedule was used to collect …

Metabolism, Fibrosis, And Apoptosis: The Effect Of Lipids And Their Derivatives On Keloid Formation, Chen-Yu Li, Ru-Xin Xie, Shi-Wei Zhang, Jiao Yun, Ai Zhong, Ying Cen, Jun-Jie Chen

Faculty, Staff and Student Publications

Keloids, pathological scars resulting from skin trauma, have traditionally posed significant clinical management challenges due to their persistence and high recurrence rates. Our research elucidates the pivotal roles of lipids and their derivatives in keloid development, driven by underlying mechanisms of abnormal cell proliferation, apoptosis, and extracellular matrix deposition. Key findings suggest that abnormalities in arachidonic acid (AA) synthesis and non-essential fatty acid synthesis are integral to keloid formation. Further, a complex interplay exists between lipid derivatives, notably butyric acid (BA), prostaglandin E2 (PGE2), prostaglandin D2 (PGD2), and the regulation of hyperfibrosis. Additionally, combinations of docosahexaenoic acid (DHA) with BA …

Severe Dysphagia With Eosinophilic Esophagitis Pattern Of Injury Related To Pembrolizumab Therapy, James S Barnett, Kevin K Yu, Xavier Rivera Rivera, Asmeen Bhatt

Faculty, Staff and Student Publications

While immune checkpoint inhibitor (ICI) therapies are effective treatments for many cancers, ICI therapies are associated with immune-related adverse events. We present a 67-year-old man with non-small cell lung carcinoma, who developed severe dysphagia with biopsies from an esophagogastroduodenoscopy showing histopathology consistent with eosinophilic esophagitis while on ICI maintenance therapy with pembrolizumab. The patient's symptoms worsened despite standard therapy. However, he had complete resolution of dysphagia symptoms once pembrolizumab was discontinued. While immune-related adverse events affecting the gastrointestinal system are increasingly recognized, ICI-associated eosinophilic esophagitis is a rare entity.

Osteopathic Manipulative Techniques (Omt) In Concussion Management: A Literature Review, Sushil Talreja, Annette Santiago

East Florida Division GME Research Day 2024

No abstract provided.

Case Study: Post-Traumatic Calcaneonavicular Coalition, Jihae Kim, James Clancy

East Florida Division GME Research Day 2024

No abstract provided.

Microbial Profile And Antimicrobial Resistance Patterns Of Surgical Intra-Abdominal Infections At A Tertiary Hospital In Tanzania A Retrospective Cross-Sectional Study, Abduel Julius Kitua

Master of Surgery

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Among infections of surgical importance, intra-abdominal infections prevail among the most common in surgical patients with considerable morbidity and mortality. The ever-rising microbial resistance to commonly available antibiotics and geographical variations in microbial profile and resistance patterns poses a challenge to the management of these surgical infections of abdominal origin. The aim of this study was to evaluate microbiological characteristics and antibiotic susceptibility of isolates from intra-abdominal infections at a tertiary hospital in Tanzania and how these influence early treatment outcomes.

Comminuted Talar Neck And Body Fracture: A Case Report, Chris Zimmer, Roshni Patel, Warren Windram

East Florida Division GME Research Day 2024

Format: Case study

Length of follow up: 12 months

Level of evidence: IV

Classification: Trauma

Purpose: A combination of talar neck and body fractures are extremely rare which make up approximately <1% of all fractures in the body. They are most commonly associated with high energy trauma such as falling from a great height, motor vehicle accident, etc. Talar fractures are challenging problems to treat in terms of fixation, rates of avascular necrosis and much more. The purpose of this case report is to demonstrate that even with a severe talar fracture salvage is possible with proper surgical technique and understanding of the unique fracture pattern.

Case study: One patient underwent ORIF of a comminuted talar neck and body fracture with a lateral bridge plate and medial based interfragmentary compression screw.

Procedures: Open reduction internal fixation of talar neck and body fracture.

Results: 1 patient who demonstrated clinical and radiographic signs of healing of a talar neck and body fracture.

Analysis & Discussions: The rates of avascular necrosis of talar neck and body fractures varies …

Nail-Plate Fixation Vs Distal Femoral Replacement For Periprosthetic Distal Femur Fractures, Matthew Mccrosson, Mamun Al Rashid

East Florida Division GME Research Day 2024

No abstract provided.