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Blunt Brachial Arterial Injury in Pediatric Patients
No full textBlunt brachial arterial injury (BBAI) is the most common vascular injury in pediatric patients. BBAI can lead to a spectrum of clinical signs and symptoms in the affected extremity, depending on the degree of occlusion and the robustness of the collateral circulation. The proper treatment ranges from expectant and conservative medical management to surgical revascularization. Although the management depends on the degree of ischemia, there is still controversy about the treatment algorithm for a pink pulseless hand following BBAI. Treatment of these pediatric vascular injuries often varies depending on the specialty of the surgeon involved. This manuscript reviews the current literature to summarize the pathophysiology, clinical presentation, diagnosis, evaluation, and best management for BBAI injury
Blunt brachial arterial injury in pediatric patients
No full textBlunt brachial arterial injury (BBAI) is the most common vascular injury in pediatric patients. BBAI can lead to a spectrum of clinical signs and symptoms in the affected extremity, depending on the degree of occlusion and the robustness of the collateral circulation. The proper treatment ranges from expectant and conservative medical management to surgical revascularization. Although management depends on the degree of ischemia, there remains controversy about the treatment algorithm for a pink pulseless hand after BBAI. Treatment of these pediatric vascular injuries often varies depending on the specialty of the surgeon involved. This article reviews the current literature to summarize the pathophysiology, clinical presentation, diagnosis, evaluation, and best management for BBAI injury
From M. chelonae to M. immunogenum: A rare case of dual nontuberculous mycobacterial infection
Get PDFTopical lifitegrast therapy for dry eye disease
Get PDFObjectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To assess the effectiveness and safety of topical lifitegrast therapy alone or in combination with artificial tears, compared with a placebo, artificial tears alone, or no treatment for dry eye disease
Empowering the adolescent voice: Resolving parent-patient conflicts in dermatologic care
No full textAre we putting our best foot forward? The effect of insurance type on ankle fracture complications and delays in care: a retrospective two-year analysis
No full textThis study investigates the influence of insurance type on delays in surgical management and postoperative complications in patients with closed operative ankle fractures. A retrospective cohort study was conducted using the PearlDiver Mariner database, analyzing 37,706 ankle fracture patients who underwent open reduction internal fixation (ORIF). Patients were grouped by insurance type (Medicaid vs private insurance), and the time from fracture diagnosis to surgery was compared. Complications including hardware infection, revision surgery, mechanical failure, nonunion, malunion, and postoperative wound issues were analyzed within two years post-surgery. A higher proportion of Medicaid patients had surgical delays beyond 10 days from initial presentation compared to privately insured patients (28.6 vs 22.2 %, p \u3c 0.001). Medicaid patients had higher rates of any orthopedic complications (odds ratio (OR): 1.27, 95 % confidence interval (CI): 1.19 - 1.37), including revision ORIF (OR: 1.33, CI: 1.16 - 1.54), mechanical failure (OR:1.24, CI: 1.03 - 1.49), nonunion or malunion (OR: 1.35, 1.17 - 1.55), and posttraumatic arthritis (OR: 1.26, 1.08 - 1.48). Although complications like wound infection and amputation were more frequent among Medicaid patients, these differences were not statistically significant. Medicaid patients experience longer delays in surgical management and higher rates of complications after ankle fractures compared to privately insured patients
Characteristics of pediatric patients with sports-related concussions: A single site retrospective review
Get PDFPURPOSE: Sports-related concussion (SRC) cases have increased among children in the last decade. Differences in concussion symptoms, presentation, and follow-up care exist when comparing demographics. The aim of this study was to explore SRC within the pediatric population. METHODS: A retrospective chart review of patients ≤ 18 years old diagnosed with SRC at a New Orleans stand-alone children\u27s hospital from January 2007 to December 2021 was performed. T-test and Fisher\u27s exact test were used for relationship between outcomes and sports, demographics, setting, insurance, and follow-up care. RESULTS: Children who sustained SRC at practice were more likely to be male (p = 0.0311) and younger (p \u3c 0.0001). Cheerleading was more likely to have injuries during practice (p \u3c 0.0001). Medicaid/uninsured patients were more likely to be referred from the emergency department (ED) (p = 0.001), have longer length of follow-ups (p = 0.0489), and have more missed appointments (p = 0.0062). However, the total number of follow-ups between insurance types did not differ (p = 0.3084). CONCLUSION: SRC incidence is situation and time dependent. Medicaid/uninsured patients are more likely to be evaluated at the ED, miss appointments, and have a longer length of follow-up to attain the same number of appointments. Exploring the nuances of SRC within this population will improve management and outcomes
Keynote Address: Triggering Toxicity: How Antibiotics Enhance the Release of Extracellular Vesicles from Escherichia Coli
No full textIdentifying and breaking barriers: Addressing disparities in the care of patients with gynecologic cancers
Get PDFBACKGROUND: Significant disparities exist in the care of patients with gynecologic malignancies. Higher incidences of gynecologic malignancies among underrepresented subpopulations (eg, racial, ethnic, and/or LGBTQAI+) and lack of representative enrollment within clinical trials have highlighted the need to improve healthcare equity. We aimed to identify barriers to equitable health care and clinical trial participation for specific diverse populations of patients with gynecologic malignancies and to identify potential solutions for overcoming these barriers. METHODS: A series of 4 live and 3 asynchronous advisory boards facilitated by GSK was conducted between January 2023 and July 2024; live advisory boards were population specific. Gynecologic oncologists, health researchers, advanced practice providers, patients, and patient advocacy group representatives who worked with and/or were themselves members of the focus population participated. Insights were compiled and analyzed to identify barriers and potential solutions across and within populations. RESULTS: Common barriers to equitable health care across all populations included cost, transportation, level of health literacy, and provider biases; 11 population-specific barriers were noted, with LGBTQAI+ patients described as facing the most barriers. Patient navigator involvement was identified as a feasible and highly impactful solution for breaking multiple barriers across various diverse populations. CONCLUSIONS: Most barriers to equitable health care were population specific, affirming the need for continued consultation and discussions with members of communities and with individuals to address specific barriers and enact effective solutions. Engagement of patient navigators was identified as an important way to improve disparities within the care of gynecologic malignancies across all underrepresented patients