Does risk stratification with a matched treatment pathway improve clinical outcomes for adults with acute back pain? A systematic review and meta-analysis.

Background: Risk stratification is an approach which has been recommended across a number of international guidelines for the management of back pain.

Objective: To assess whether the use of risk stratification with a matched treatment pathway improves clinical outcomes, when compared with usual care or other interventions, in adults with acute back pain.

Methods: A comprehensive search was conducted of the databases Medline, Embase, PEDro, CINAHL and Cochrane Library in November 2022.

Parathyroid hormone-driven algorithms after thyroid surgery: Not one-size-fits-all.

Background: Underreported variation in parathyroid hormone (PTH) assays exists. Using quality improvement methods, we aimed to develop an institution-specific PTH-based protocol to predict hypocalcemia after thyroidectomy.

Methods: We retrospectively reviewed patients who underwent total/completion thyroidectomy.

Theoretical Schemas to Guide Back Pain Consortium (BACPAC) Chronic Low Back Pain Clinical Research.

Background: Chronic low back pain (cLBP) is a complex with a heterogenous clinical presentation. A better understanding of the factors that contribute to cLBP is needed for accurate diagnosis, optimal treatment, and identification of mechanistic targets for new therapies. The Back Pain Consortium (BACPAC) Research Program provides a unique opportunity in this regard, as it will generate large clinical datasets, including a diverse set of harmonized measurements.

Improving resident confidence with a low-cost interventional spine course.

Background: Procedure training is highly desired by residents pursuing a career in interventional pain medicine; however, the opportunities for hands-on training may vary amongst residency programs for various reasons.

Objective: To evaluate the change in residents' self-perceive competence after participation in a novel low-cost resident interventional spine course, as well as how resident experience (years of training) influences change over time. This article offers step-by-step details on how to implement a resident interventional spine course.

A Conversation Between Past and Present Chairs of the American Board of Physical Medicine and Rehabilitation: Four Decades of History and the Future of Board Certification.

On the 75th anniversary of the founding of the American Board of Physical Medicine and Rehabilitation, 11 of the surviving chairs of the board convened virtually to reflect on the past 40 years of major trends for the accrediting body of physiatrists. The field rapidly expanded in the 1980s, driven by changes in the reimbursement environment. This rapid expansion drove an improvement in the caliber of residents choosing the field and in the quality of training programs.

Late-term fetuses with reduced umbilical vein blood flow volume: An under-recognized population at increased risk of growth restriction.

Objectives: To investigate the umbilical vein and uterine arteries blood flow volume (UV-Q, UtA-Q) in late-term pregnancies.

Study Design: This was a prospective observational cohort study of singleton pregnancies ≥40 + 0 weeks in which UV-Q and UtA-Q, both absolute and normalized for estimated fetal weight (EFW) values, were evaluated in relation to AC drop of ≥20 percentiles from 20 weeks to term, Doppler signs of fetal cerebral blood flow redistribution and composite adverse perinatal outcome. The presence of neonatal hypoglycaemia and the need of formula milk supplementation were also examined.

Asbestos containing materials in schools of Rome and surrounding area (Italy).

Despite Italy banning use and production of asbestos in 1992, it continues to represent a risk to human health due to its permanence in the places where it was located. The aim of this work is to estimate how many schools in Rome (Italy) have asbestos containing materials (ACM), and to assess whether the location, condition and nature of ACM can influence the level of risk for student health. 3,672 schools were contacted and 1,451 participated to asbestos survey.

Is Sleep Disordered Breathing Confounding Rehabilitation Outcomes in Spinal Cord Injury Research?

The purpose of this article is to highlight the importance of considering sleep-disordered breathing (SDB) as a potential confounder to rehabilitation research interventions in spinal cord injury (SCI). SDB is highly prevalent in SCI, with increased prevalence in individuals with higher and more severe lesions, and the criterion standard treatment with continuous positive airway pressure remains problematic. Despite its high prevalence, SDB is often untested and untreated in individuals with SCI.

Feasibility and Safety of Outpatient Thyroidectomy: A Narrative Scoping Review.

Background: Outpatient thyroid surgery is gaining popularity as it can reduce length of hospital stay, decrease costs of care, and increase patient satisfaction. There remains a significant variation in the use of this practice including a perceived knowledge gap with regards to the safety of outpatient thyroidectomies and how to go about implementing standardized institutional protocols to ensure safe same-day discharge. This review summarizes the information available on the subject based on existing published studies and guidelines.

Surgical Tray Optimization: a Quality Improvement Initiative that Reduces Operating Room Costs.

Surgical trays contain unused instruments which generate wasted resources from unnecessary reprocessing/replacement costs. We implemented a quality improvement initiative to optimize surgical trays for common otolaryngology procedures, and examined the impact on costs, operating room (OR) efficiency, and patient safety.We studied five common otolaryngology procedures over a 10-month period at a single community hospital.

Evidence of bacterial DNA presence in chorionic villi and amniotic fluid in the first and second trimester of pregnancy.

The sterile-womb dogma in uncomplicated pregnancy has been lively debated. Data regarding the microbiome environment are based mainly on studies performed at the time of delivery. To determine whether human placenta and amniotic fluid are populated by a bacterial microbiota in the first and second trimesters of pregnancy.

Patient Perspectives on Removing Adult Tonsillectomy and Septoplasty from the Government Health Insurance Plan in a Publicly Funded Health Care System.

In several publicly funded health care systems, including Ontario, Canada, adult tonsillectomies and septoplasties have been suggested to be removed or "delisted" from the government health insurance plan. Thus, the objective of this study was to explore patient perspectives regarding out of pocket (OOP) payment for these procedures. An anonymous survey was administered to patients consented to undergo a tonsillectomy or septoplasty at a community otolaryngology-head and neck surgery (OHNS) practice.

Targeted genome editing in vivo corrects a Dmd duplication restoring wild-type dystrophin expression.

Tandem duplication mutations are increasingly found to be the direct cause of many rare heritable diseases, accounting for up to 10% of cases. Unfortunately, animal models recapitulating such mutations are scarce, limiting our ability to study them and develop genome editing therapies. Here, we describe the generation of a novel duplication mouse model, harboring a multi-exonic tandem duplication in the Dmd gene which recapitulates a human mutation.

Weight gain during pregnancy in women with HIV receiving different antiretroviral regimens.

Background: No published studies have evaluated in pregnant women with HIV weight gain with different antiretroviral drug classes.

Methods: Data from a national cohort study were used. We compared absolute weight gain and occurrence of excessive weight gain in women with HIV who received during pregnancy integrase inhibitors (INSTI), protease inhibitors (PI), or non-nucleoside reverse transcriptase inhibitors (NNRTI).

Urine Metabolome during Parturition.

In recent years, some studies have described metabolic changes during human childbirth labor. Metabolomics today is recognized as a powerful approach in a prenatal research context, since it can provide detailed information during pregnancy and it may enable the identification of biomarkers with potential diagnostic or predictive. This is an observational, longitudinal, prospective cohort study of a total of 51 serial urine samples from 15 healthy pregnant women, aged 29-40 years, which were collected before the onset of labor (out of labor, OL).

Psychological Morbidity and Chronic Disease Among Adults With Traumatic Spinal Cord Injuries: A Longitudinal Cohort Study of Privately Insured Beneficiaries.

Objective: To compare the longitudinal incidence of psychological morbidities and multimorbidity and estimates of chronic diseases among adults with spinal cord injuries (SCIs) as compared with adults without SCIs.

Methods: Privately insured beneficiaries who had medical coverage at any time between January 1, 2001, and December 31, 2017 were included if they had an International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic code for a traumatic SCI (n=6,847).

Results: Adults with SCIs (n=6847) had a higher incidence of adjustment reaction (7.

Psychological morbidity and chronic disease among adults with nontraumatic spinal cord injuries: a cohort study of privately insured beneficiaries.

Background: Individuals living with a spinal cord injury (SCI) are at heightened risk for a number of chronic health conditions such as secondary comorbidities that may develop or be influenced by the injury, the presence of impairment, and/or the process of aging. However, very little is known about the development of secondary comorbidities among individuals living with nontraumatic SCIs (NTSCIs).

Purpose: The objective of this study was to compare the prevalence of psychological morbidities and chronic diseases among adults with and without NTSCIs.

Should There Be A Part II ABPMR Examination?: A Psychometric Inquiry.

Background: Certification by the American Board of Physical Medicine and Rehabilitation (ABPMR) requires passing both a written multiple choice examination (Part I) and an oral examination (Part II), but it has been unclear whether the two examinations measure the same or different dimensions of knowledge.

Objective: To evaluate the concordance between the Part I and Part II examinations for ABPMR initial certification with regard to candidate performance on the examinations and their subsets. Our question is whether the Part II examination provides additional assessment of a candidate beyond what Part I provides.

Burnout in Diplomates of the American Board of Physical Medicine and Rehabilitation-Prevalence and Potential Drivers: A Prospective Cross-Sectional Survey.

Background: Physician burnout is of growing concern. Burnout among physical medicine and rehabilitation (PM&R) physicians has shown a significant increase, positioning PM&R as one of the most "burned out" of specialties. Little has been written about potential factors contributing to physiatrist burnout or potential interventions.

Urinary profiles associated with bacterial metabolites from asymptomatic pregnant women with at term or preterm premature rupture of membranes: a pilot study.

Premature rupture of membranes (PROM) and preterm premature rupture of membranes (pPROM) are frequent conditions with a not fully understood multifactorial etiology. It has been suggested that infection may be the leading cause of pPROM. Metabolomics is nowadays recognized as a successful and versatile approach for the investigation of several pathological conditions, including pregnancy-related ones.

Administration and performance on the Spinal Cord Injury Medicine Certification Examination over a 10-year period.

: The examination for Spinal Cord Injury (SCI) Medicine subspecialty certification has been administered since 1998, but published information about exam performance or administration is limited. Retrospective review : We examined de-identified information from the American Board of Physical Medicine and Rehabilitation (ABPMR) database for characteristics and performance of candidates (n = 566) who completed the SCI Medicine Examination over a 10-year period (2005-2014), during which the exam outline and passing standard remained consistent. Not applicable : We analysed candidate performance by candidate track, primary specialty, number of attempts, and domains being tested.