scholarly journals Is Footedness Driving Right Lower Extremity Arthroplasty Becoming Commoner Than Left Lower Extremity Arthroplasty?

2021 ◽  
Author(s):  
Deepak Gupta
Keyword(s):  
Lower Extremity ◽  
Automatic Transmission ◽  
Revision Arthroplasty ◽  
The United States ◽  
Left Lower Extremity ◽  
Institutional Review ◽  
Number Of Patients ◽  
Wear And Tear ◽  
Primary Hip Arthroplasty ◽  
Set Up

The question arises whether footedness transforms into asymmetrical incidence of wear and tear within lower extremity joints. After obtaining institutional review board approval for exempt research, the author manually counted the number of patients who underwent right or left or bilateral, hip or knee, primary or revision arthroplasty over a five-year period (2016-2020) at a university-affiliated hospital in the United States. Overall, right lower extremity arthroplasty was significantly commoner than left lower extremity arthroplasty (P=0.002). Individually, only right primary hip arthroplasty (P=0.033) and right revision knee arthroplasty (P=0.041) were significantly commoner procedures than their left counterparts. These results should set up the stage for future investigations into footedness retrospectively and prospectively to rule out if commoner right footedness in itself is driving this asymmetrical incidence of lower extremity arthroplasty or whether automatic transmission vehicular driving is independently contributing to this asymmetrical incidence.

scholarly journals Tuberculous Pyomyositis: A Rare but Serious Diagnosis

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Vikram Krishnasamy ◽  
Matthew Joseph
Keyword(s):  
Lower Extremity ◽  
Poor Prognosis ◽  
Multiorgan Failure ◽  
Laboratory Data ◽  
The United States ◽  
Past Medical History ◽  
Blood Cell Count ◽  
Large Area ◽  
Left Lower Extremity ◽  
History Of

Tuberculous pyomyositis is a rare clinical entity with serious consequences if a diagnosis is not established early. A 53-year-old female with a past medical history of sarcoidosis and pulmonary fibrosis presented from an outside hospital with persistent fevers and a rash. She had been hospitalized multiple times at an outside hospital without any improvement in her symptoms. On examination, she was noted to have a large area of left upper lower extremity (LUE) tenderness with superimposed erythema. Laboratory data revealed a white blood cell count of 22,300. Computed tomography (CT) scans of the LUE, chest, and left lower extremity (LLE) showed multiple intramuscular abscesses in those regions without evidence of osteomyelitis. Subsequent drainage of the abscesses and resulting cultures revealedMycobacterium tuberculosis. The patient was started on therapy with rifampin, isoniazid, pyrazinamide, and ethambutol. However, the patient developed hepatitis on these agents and subsequently went into septic shock with multiorgan failure. Care was eventually withdrawn as a result of a poor prognosis. This case illustrates the severe consequences of TB pyomyositis if not diagnosed promptly. While tuberculosis is uncommon in the United States, it should be an important consideration in the differential diagnosis of immunocompromised patients.

Electronic cigarettes: How confident and effective are allergists, pulmonologists, and primary care physicians in their practice behavior?

2020 ◽  
Vol 41 (3) ◽  
pp. 192-197
Author(s):  
Sherry S. Zhou ◽  
Alan P. Baptist
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Electronic Cigarettes ◽  
The United States ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Knowledge And Beliefs ◽  
Tobacco Cigarette ◽  
Number Of Patients ◽  
Personal Use

Background: There has been a striking increase in electronic cigarette (EC) use in the United States. The beliefs and practices toward ECs among physicians are unknown. Objective: The purpose of this study was to investigate EC practice patterns among allergists, pulmonologists, and primary care physicians. Methods: An anonymous survey was sent to physicians. The survey contained 32 questions and addressed issues related to demographics, cessation counseling behaviors, personal use, and knowledge and beliefs about ECs. Statistical analysis was performed by using analysis of variance, the Pearson χ2 test, Fisher exact test, and logistic regression. Results: A total of 291 physicians completed the survey (222 primary care physicians, 33 pulmonologists, and 36 allergists) for a response rate of 46%. The allergists asked about tobacco cigarette use as frequently as did the pulmonologists and more than the primary care physicians (p < 0.001), but they rarely asked about EC use. The pulmonologists scored highest on self-reported knowledge on ECs, although all the groups answered <40% of the questions correctly. The allergists did not feel as comfortable about providing EC cessation counseling as did the pulmonologists and primary care physicians (p < 0.001). All three groups were equally unlikely to recommend ECs as a cessation tool for tobacco cigarette users. Conclusion: Allergists lacked knowledge and confidence in providing education and cessation counseling for EC users. As the number of patients who use these products continues to increase, there is an urgent need for all physicians to be comfortable and knowledgeable with counseling about ECs.

Identify Compounds' Target Against Alzheimer's Disease Based on In-Silico Approach

2019 ◽  
Vol 16 (3) ◽  
pp. 193-208 ◽  
Author(s):  
Yan Hu ◽  
Guangya Zhou ◽  
Chi Zhang ◽  
Mengying Zhang ◽  
Qin Chen ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Small Molecule ◽  
Characteristic Curve ◽  
Machine Learning Algorithms ◽  
Learner Model ◽  
Mao B ◽  
Number Of Patients ◽  
Sar Model ◽  
Set Up

Background: Alzheimer's disease swept every corner of the globe and the number of patients worldwide has been rising. At present, there are as many as 30 million people with Alzheimer's disease in the world, and it is expected to exceed 80 million people by 2050. Consequently, the study of Alzheimer’s drugs has become one of the most popular medical topics. Methods: In this study, in order to build a predicting model for Alzheimer’s drugs and targets, the attribute discriminators CfsSubsetEval, ConsistencySubsetEval and FilteredSubsetEval are combined with search methods such as BestFirst, GeneticSearch and Greedystepwise to filter the molecular descriptors. Then the machine learning algorithms such as BayesNet, SVM, KNN and C4.5 are used to construct the 2D-Structure Activity Relationship(2D-SAR) model. Its modeling results are utilized for Receiver Operating Characteristic curve(ROC) analysis. Results: The prediction rates of correctness using Randomforest for AChE, BChE, MAO-B, BACE1, Tau protein and Non-inhibitor are 77.0%, 79.1%, 100.0%, 94.2%, 93.2% and 94.9%, respectively, which are overwhelming as compared to those of BayesNet, BP, SVM, KNN, AdaBoost and C4.5. Conclusion: In this paper, we conclude that Random Forest is the best learner model for the prediction of Alzheimer’s drugs and targets. Besides, we set up an online server to predict whether a small molecule is the inhibitor of Alzheimer's target at http://47.106.158.30:8080/AD/. Furthermore, it can distinguish the target protein of a small molecule.

Mosquito and Tick-borne Illnesses in the United States. Guidelines for the Recognition and Empiric Treatment of Zoonotic Diseases in the Wilderness.

2019 ◽  
Vol 19 (3) ◽  
pp. 238-257
Author(s):  
Suresh Antony
Keyword(s):  
United States ◽  
Lyme Disease ◽  
Spotted Fever ◽  
Disease Process ◽  
Rocky Mountain ◽  
The United States ◽  
Health Care Facilities ◽  
Diagnostic Tools ◽  
Rocky Mountain Spotted Fever ◽  
Number Of Patients

Background:In the United States, tick-borne illnesses account for a significant number of patients that have been seen and treated by health care facilities. This in turn, has resulted in a significant morbidity and mortality and economic costs to the country.Methods:The distribution of these illnesses is geographically variable and is related to the climate as well. Many of these illnesses can be diagnosed and treated successfully, if recognized and started on appropriate antimicrobial therapy early in the disease process. Patient with illnesses such as Lyme disease, Wet Nile illness can result in chronic debilitating diseases if not recognized early and treated.Conclusion:This paper covers illnesses such as Lyme disease, West Nile illness, Rocky Mountain Spotted fever, Ehrlichia, Tularemia, typhus, mosquito borne illnesses such as enteroviruses, arboviruses as well as arthropod and rodent borne virus infections as well. It covers the epidemiology, clinical features and diagnostic tools needed to make the diagnosis and treat these patients as well.

"Taming the Monster aka Uncontrolled Diabetes: A Viewpoint" (Preprint)

2020 ◽  
Author(s):  
Swati Anand ◽  
Amardeep Kalsi ◽  
Jonathan Figueroa ◽  
Parag Mehta
Keyword(s):  
Blood Glucose ◽  
Diabetes Management ◽  
Positive Impact ◽  
The United States ◽  
Phone Call ◽  
Diabetic Patients ◽  
Dietary Compliance ◽  
Glucose Levels ◽  
Uncontrolled Diabetes ◽  
Number Of Patients

BACKGROUND HbA1c between 6% and 6.9% is associated with the lowest incidence of all‐cause and CVD mortality, with a stepwise increase in all‐cause and cardiovascular mortality in those with an HbA1c >7%. • There are 30 million individuals in the United States (9.4% of the population) currently living with Diabetes Mellitus. OBJECTIVE Improving HbA1C levels in patients with uncontrolled Diabetes with a focused and collaborative effort. METHODS Our baseline data for Diabetic patients attending the outpatient department from July 2018 to July 2019 in a University-affiliated hospital showed a total of 217 patients for one physician. • Of 217 patients, 17 had HbA1C 9 and above. We contacted these patients and discussed the need for tight control of their blood glucose levels. We intended to ensure them that we care and encourage them to participate in our efforts to improve their outcome. • We referred 13 patients that agreed to participate to the Diabetic educator who would schedule an appointment with the patients, discuss their diet, exercise, how to take medications, self-monitoring, and psychosocial factors. • If needed, she would refer them to the Nutritionist based on patients’ dietary compliance. • The patients were followed up in the next two weeks via telemedicine or a phone call by the PCP to confirm and reinforce the education provided by the diabetes educator. RESULTS Number of patients that showed an improvement in HbA1C values: 11 Cumulative decrease in HbA1C values for 13 patients: 25.3 The average reduction in HbA1C: 1.94 CONCLUSIONS Our initiative to exclusively target the blood glucose level with our multidisciplinary approach has made a positive impact, which is reflected in the outcome. • It leads to an improvement in patient compliance and facilitates diabetes management to reduce the risk for complications CLINICALTRIAL NA

How Research Will Adapt to HIPAA: A View from Within the Healthcare Delivery System

2002 ◽  
Vol 28 (4) ◽  
pp. 491-502
Author(s):  
Mary L. Durham
Keyword(s):  
Health Information ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
The United States ◽  
Personal Health Information ◽  
Personal Health ◽  
Business Associations ◽  
Electronic Information ◽  
Healthcare Delivery System ◽  
Institutional Review

While the new Health Insurance Privacy and Accountability Act (HIPAA) research rules governing privacy, confidentiality and personal health information will challenge the research and medical communities, history teaches us that the difficulty of this challenge pales in comparison to the potential harms that such regulations are designed to avoid. Although revised following broad commentary from researchers and healthcare providers around the country, the HIPAA privacy requirements will dramatically change the way healthcare researchers do their jobs in the United States. Given our reluctance to change, we risk overlooking potentially valid reasons why access to personal health information is restricted and regulated. In an environment of electronic information, public concern, genetic information and decline of public trust, regulations are ever-changing. Six categories of HIPAA requirements stand out as transformative: disclosure accounting/tracking, business associations, institutional review board (IRB) changes, minimum necessary requirements, data de-identification, and criminal and civil penalties.

scholarly journals Multidimensional Sleep Health and Physical Functioning in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 428-428
Author(s):  
Caitlan Tighe ◽  
Ryan Brindle ◽  
Sarah Stahl ◽  
Meredith Wallace ◽  
Adam Bramoweth ◽  
...  
Keyword(s):  
Older Adults ◽  
Lower Extremity ◽  
Grip Strength ◽  
Physical Functioning ◽  
Gait Speed ◽  
The United States ◽  
Depression Symptoms ◽  
Sleep Health ◽  
Lower Extremity Strength ◽  
Sleep Parameters

Abstract Prior studies link specific sleep parameters to physical functioning in older adults. Recent work suggests the utility of examining sleep health from a multidimensional perspective, enabling consideration of an individual’s experience across multiple different sleep parameters (e.g., quality, duration, timing). We examined the associations of multidimensional sleep health with objective, performance-based measures of physical functioning in older adults. We conducted a secondary analysis of 158 adults (Mage=71.8 years; 51.9% female) who participated in the Midlife in the United States (MIDUS) 2 and MIDUS Refresher studies. We used data from daily diaries, wrist actigraphy, and self-report measures to derive a composite multidimensional sleep health score ranging from 0-6, with higher scores indicating better sleep health. Physical function was assessed using gait speed during a 50-foot timed walk, lower extremity strength as measured by a chair stand test, and grip strength assessed with dynamometers. We used hierarchical regression to examine the associations between sleep health and gait speed, lower extremity strength, and grip strength. Age, sex, race, education, depression symptoms, medical comorbidity, and body mass index were covariates in each model. In adjusted analyses, better multidimensional sleep health was significantly associated with faster gait speed (B=.03, p=.01). Multidimensional sleep health was not significantly associated with lower limb strength (B=-.12, p=.89) or grip strength (B=.45, p=.40). Gait speed is a key indicator of functional capacity as well as morbidity and mortality in older adults. Multidimensional sleep health may be a therapeutic target for improving physical functioning and health in older adults.

scholarly journals Photosensitizing Medications and Skin Cancer: A Comprehensive Review

Cancers ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2344
Author(s):  
Elisabeth A. George ◽  
Navya Baranwal ◽  
Jae H. Kang ◽  
Abrar A. Qureshi ◽  
Aaron M. Drucker ◽  
...  
Keyword(s):  
Skin Cancer ◽  
Cancer Risk ◽  
Cell Carcinoma ◽  
The United States ◽  
In Vivo Studies ◽  
Cancer Risk Factors ◽  
Skin Cancer Risk ◽  
Number Of Patients

(1) The incidence of skin cancer is increasing in the United States (US) despite scientific advances in our understanding of skin cancer risk factors and treatments. In vitro and in vivo studies have provided evidence that suggests that certain photosensitizing medications (PSMs) increase skin cancer risk. This review summarizes current epidemiological evidence on the association between common PSMs and skin cancer. (2) A comprehensive literature search was conducted to identify meta-analyses, observational studies and clinical trials that report on skin cancer events in PSM users. The associated risks of keratinocyte carcinoma (squamous cell carcinoma and basal cell carcinoma) and melanoma are summarized, for each PSM. (3) There are extensive reports on antihypertensives and statins relative to other PSMs, with positive and null findings, respectively. Fewer studies have explored amiodarone, metformin, antimicrobials and vemurafenib. No studies report on the individual skin cancer risks in glyburide, naproxen, piroxicam, chlorpromazine, thioridazine and nalidixic acid users. (4) The research gaps in understanding the relationship between PSMs and skin cancer outlined in this review should be prioritized because the US population is aging. Thus the number of patients prescribed PSMs is likely to continue to rise.

scholarly journals Infection Prevention Considerations for a Multi-Mission Convention Center Field Hospital in Baltimore, Maryland during the COVID-19 Pandemic

2021 ◽  
pp. 1-21
Author(s):  
Jennifer A. Jones ◽  
Zishan K. Siddiqui ◽  
Charles Callahan ◽  
Surbhi Leekha ◽  
Sharon Smyth ◽  
...  
Keyword(s):  
Best Practices ◽  
Infection Prevention ◽  
Diagnostic Testing ◽  
The United States ◽  
Infection Prevention And Control ◽  
Field Hospital ◽  
First Case ◽  
Convention Center ◽  
Set Up ◽  
And Control

Abstract The state of Maryland identified its first case of COVID-19 on March 5, 2020. The Baltimore Convention Center (BCCFH) quickly became a selected location to set up a 250-bed inpatient Field Hospital and Alternate Care Site. In contrast to other field hospitals throughout the United States, the BCCFH remained open throughout the pandemic and took on additional COVID-19 missions, including community SARS-CoV-2 diagnostic testing, monoclonal antibody infusions for COVID-19 outpatients, and community COVID-19 vaccinations. At the time of publication, the BCCFH had cared for 1,478 COVID-19 inpatients, performed 108,155 COVID-19 tests, infused 2,166 COVID-19 patients, and administered 115,169 doses of COVID-19 vaccine. To prevent the spread of pathogens during operations, infection prevention and control guidelines were essential to ensure the safety of staff and patients. Through multi-agency collaboration, utilization of infection prevention best practices, and answering what we describe as “PPE-ESP”, an operational framework was established to reduce infection risks for those providing or receiving care at the BCCFH during the COVID-19 pandemic.

scholarly journals Representing, commemorating, and memorizing terrorist attacks: Discussing the US and French experiences

2021 ◽  
pp. 263300242110244
Author(s):  
Alice M. Greenwald ◽  
Clifford Chanin ◽  
Henry Rousso ◽  
Michel Wieviorka ◽  
Mohamed-Ali Adraoui
Keyword(s):  
Historical Context ◽  
The United States ◽  
Terrorist Attacks ◽  
The Political ◽  
Modes Of Operation ◽  
The Us ◽  
Places Of Memory ◽  
Similarities And Differences ◽  
Set Up ◽  
Do So

How do societies and states represent the historical, moral, and political weight of the terrorist attacks they have had to face? Having suffered in recent years from numerous terrorist attacks on their soil originating from jihadist movements, and often led by actors who were also their own citizens, France and the United States have set up—or seek to do so—places of memory whose functions, conditions of creation, modes of operation, and nature of the messages sent may vary. Three of the main protagonists and initiators of two museum-memorial projects linked to terrorist attacks have agreed to deliver their visions of the role and of the political, social, and historical context in which these projects have emerged. Allowing to observe similarities and differences between the American and French approach, this interview sheds light on the place of memory and feeling in societies struck by tragic events and seeking to cure their ills through memory and commemoration.

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