DigitalCommons@KCU (Kansas City Univ.)
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Misted Memories
No full textOil Paint.
Misted Memory is inspired by the ocean\u27s waves and the way their mist blurs reality. I hope to explore the sense of nostalgia and fleeting serenity, illustrating the way dreams and recollections fade yet linger
Reevaluating Electroencephalography Monitoring in Koolen-de Vries Syndrome: A Case of Delayed Focal Impaired Consciousness Seizure Diagnosis
Get PDFKoolen-de Vries syndrome (KdVS) is a rare multisystem genetic disorder due to deletions in the KANSL1 gene. The most common type of seizure documented in these patients is focal impaired consciousness seizure (FICS). These seizures present with difficult-to-distinguish characteristics, including autonomic symptoms, brief loss of consciousness, and post-ictal confusion. The ambiguity of this presentation can make it difficult to detect clinically. This case presents an eight-year-old male child with KdVS who presented to the clinic with complaints of increased outbursts, spatial disorientation, issues with mood and self-regulation, and episodes of “spacing out” as noted by his teacher. The initial diagnosis was dysautonomia and was conservatively managed. However, due to worsening neurocognitive outcomes, neurological referral and work-up were initiated to further elucidate the etiology of his symptoms. The patient\u27s electroencephalography (EEG) findings showed frequent focal sharp waves consistent with FICS. He was then treated accordingly with diazepam and amantadine, which led to a significant improvement in neurological status. This case highlights the importance of the use of EEG in KdVS patients, as well as the implications of implementing guidelines recommending the low threshold required for use of EEG and full neurological work-up for patients with any alarm symptoms possibly indicative of FICS or other epileptiform activity
Have Modern Total Knee Arthroplasty Implant Improvements Affected Revision Rates? A Registry Review of Modern Implants and their Predecessors
Get PDFIntroduction
Total knee arthroplasty (TKA) is a common orthopaedic procedure used to alleviate pain and restore mobility in patients with knee pain. Substantial resources are committed to updating and refining new knee implant designs to improve outcomes. The aim of this study was to compare revision rates and failure modes between newer implants and their older counterparts.
Methods
A systematic literature review of national registries was conducted to identify predecessor and successor implant designs from four manufacturers. Individual implant revision data points for each implant design across the registries were compared between generations by manufacturer. Reported revision rates of TKA implant designs were analyzed in addition to implant type and method of fixation when available. Additionally, TKA revision indications were collected and compared between registries.
Results
We found no differences in revision rates between newer implant designs and their older counterparts at any recorded time point between 1 and 15 years. A meta-analysis compared the indication percentages for infection, loosening, mechanical complication, instability, pain, wear, fracture, and stiffness and showed significant differences between registries (P\u3c0.001).
Conclusion
The study’s findings showed comparable revision rates between successor and predecessor TKA implant designs. Other parameters, such as patient satisfaction and functional outcomes, are necessary to demonstrate the value of a new implant
Validity and Reliability of a Single-unit Inertial Measurement Unit: A Real-time Adapted Sports Assessment Tool for Handcycling-based Activities
No full textPurpose: Single-device wearable inertial measurement units (SWIMU) have been used to quantify able-bodied sports movement in real-time but have not been adequately validated for use in adapted sports. Access to the kinematic profile of adapted sport athletic movements may be important for understanding the effect of technique on performance, fatigue and injury risk. The purpose of this study was to assess the validity and reliability of a SWIMU during upper-body sports movement in people with physical disabilities.
Materials and methods: Seven people with disabilities completed three handcycling sessions while wearing a SWIMU on their right wrist. During session 1, motion capture markers were also placed on participants where they completed three (3) 15-s trials at a self-selected cadence. Kinematic data from Motion Capture System was compared to SWIMU data. During sessions 2 and 3, participants cycled at 10 mph for 20 revolutions. SWIMU data was compared across sessions 2 and 3 to determine its reliability.
Results: Linear acceleration measured through a SWIMU and Motion Capture System was highly correlated in the x-axis (r = .80) and moderately highly correlated in the y-axis (r = .70) and z-axis (r = .68; p\u3c.001). SWIMU had excellent intraclass correlation (ICC) across all axes (ICC \u3e .75; p\u3c.001).
Conclusions: A SWIMU is valid and reliable during ergometry-related movement in people with disabilities. SWIMU have the potential to provide real-time feedback to adapted sports participants and trainers on sports-specific technique during a single training session and across multiple sessions
Filling the Gap: Facial Anatomy and Safe Lower Lip Injection Practices
Get PDFBackground/Objectives: Anatomical knowledge of the arterial supply to the lower face is critical to prevent unnecessary harm to patients seeking cosmetic procedures, particularly lower lip dermal filler injections. Our study sought to characterize the prominent vascular structures of the lower lip: inferior labial (ILA), labiomental (LMA) and mental (MA) arteries.
Methods: Forty-eight hemiface specimens from 30 formalin-embalmed donors were utilized in this study. Dissection was performed of the LMA, ILA, and MA to determine their diameter, branching pattern for characterization, and to assess their supply to the lip distally.
Results: The ILA (mean diameter, 1.5 ± 0.49 mm) was found to be prevalent in 90% of sampled donors. The LMA (1.2 ± 0.53 mm) was found in 75% of donors. All 48 hemifaces were found to have a MA (1.6 ± 0.51 mm). 88% of ILAs, 43% of LMAs, and 96% of MAs were identified as directly supplying the lower lip. Mean location of the MA as it supplied the lower lip was determined to be (−17 mm, −8.2 mm) and (20 mm, −8.1 mm) in the left and right hemifaces, respectively. F-Test for variance found no significant differences amongst the horizontal (p = 0.82) and vertical distances (p = 0.41) bilaterally.
Conclusions: Our findings demonstrate the high variability in vascular supply of the lower lip, suggesting the need for high-resolution ultrasound guidance and the integration of anatomical training within injection courses for the safe injection of dermal fillers
Challenges in Managing Recurrent Small Bowel Obstruction in a Patient With Concurrent Hepatic Dysfunction and Alcohol Use Disorder: A Multidisciplinary Approach
Get PDFThis case report describes a 63-year-old Black man with recurrent small bowel obstruction (SBO), persistent abdominal pain, and hepatic dysfunction, set against a complex background of idiopathic peripheral neuropathy, chronic hepatomegaly, an indeterminate adrenal mass, and long-term alcohol use. Imaging revealed dilated bowel loops with partial obstruction, while laboratory findings showed elevated liver enzymes indicative of hepatic impairment. His clinical course highlighted the multifactorial nature of SBO, likely influenced by anatomical disruptions, hepatic pathology, and systemic metabolic factors, including potential adrenal involvement. The case emphasizes the importance of a multidisciplinary approach integrating gastroenterology, hepatology, and endocrinology to manage such intricate presentations. It also underscores the role of chronic alcohol use in exacerbating gastrointestinal and hepatic conditions, advocating for a holistic treatment strategy to optimize outcomes
Medial Plantar Artery Dominance of the Plantar Arterial Arch: A Unique Anastomosis with Clinical Implications
Get PDFIntroduction: Forefoot structures are vascularized through the deep plantar arch, an anastomotic network classically described between the deep branch of the lateral plantar artery (dLPA) and the deep plantar artery (DPA). While it supplies the medial aspect of the plantar foot, the medial plantar artery (MPA) is not described as providing a vascular contribution to the deep plantar arterial arch.
Case Report: During routine cadaveric dissection of bilateral lower extremities in a 96-year-old Caucasian male, a unique anomaly was noted within the deep plantar arterial arch. The superficial branch of the medial plantar artery (sMPA) was found to course laterally at the level of the first metatarsophalangeal joint and anastomose with the DPA to form the deep plantar arch. No contribution was noted from the LPA. A total of 89 feet from 49 cadavers were subsequently examined, and no other donors exhibited this distinct morphology, resulting in an estimated prevalence of 2.3% of feet.
Conclusion: This case study describes a novel bilateral plantar vascular anomaly and reviews the potential clinical significance of this variant, which should be considered during various reconstructive flap procedures of the foot
An Analysis of the Accuracy, Quality, and Readability of Online Health Information for Interstitial Cystitis/Bladder Pain Syndrome
No full textObjective: To assess the accuracy, quality, and readability of online health information for interstitial cystitis/bladder pain syndrome (IC/BPS).
Methods: Two search engines, Google and Bing, were queried using the search terms interstitial cystitis treatment and bladder pain syndrome treatment. The first 20 websites from each search were recorded. Duplicate websites between searches were removed and a predetermined set of inclusion and exclusion criteria were applied to screen websites. Two Urogynecology and Reconstructive Pelvic Surgery fellowship-trained Urologists assessed the accuracy of websites on a 1-5 Likert scale. The quality of websites was assessed using the DISCERN tool. The readability of websites was assessed using the Flesch-Kincaid Reading Ease (FKRE), Flesch-Kincaid Reading Level (FKRL), and SMOG indexes.
Results: After screening, 25 individual websites were included for assessment. The accuracy of websites was high, with a median accuracy rating of 4 (accuracy of 75-99%). The quality of the websites was fair, with a median score of 42 (scale: 1-75). The readability of websites was poor, with a median FKRE of 45.8 (scale: 1-100), median FKRL of 10.6, indicating a 10th-grade reading level, and SMOG of 13, indicating a college reading level.
Discussion: Accuracy and quality of the top searched IC/BPS websites are adequate, but readability is poor. Further efforts should ensure that online health information is formatted at a reading level of 6th grade or below