Wounds and Injuries Commons^™

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.