Decreasing Hip Offset in Total Hip Arthroplasty Results in Decreased Physical Function Scores.

Background: Acetabular and femoral offset play an important role in total hip arthroplasty (THA) for postoperative stability and biomechanical function. However, it is unknown whether offset impacts patient-reported outcomes (PROs). This study evaluated patients undergoing direct anterior (DA) THA with the hypothesis that patients who have a decrease in hip offset postoperatively would have lower physical function scores and higher pain interference.

Risk Factors of Failure to Discharge Before "Two Midnights" in Outpatient-Designated Total Hip Arthroplasty.

Introduction: The Centers for Medicare and Medicaid Services removed total hip arthroplasty (THA) from the inpatient-only list but continued to classify admissions as inpatient if they include two midnights, complicating care if an outpatient THA requires extended hospitalization. This study evaluates risk factors of patients undergoing outpatient-designated THA with a length of stay (LOS) ≥ 2 days.

Methods: A total of 17,063 THA procedures designated as outpatient in the National Surgical Quality Improvement Program database between 2015 and 2020 were stratified by LOS < 2 days (n = 2,294, 13.

Facebook Data Analytics: An Orthopedic Arthroplasty Case Study and Guide for Physicians.

Social media is increasingly used for health queries and subspecialist selection, but physicians receive little training in its use. This case study describes use of the free data tool Facebook Audience Insights to understand population demographics relevant to an orthopedic practice. Facebook Audience Insights was used to compare demographics and activity patterns of two patient samples typical of total joint arthroplasty (TJA)-young TJA (ages 55-64 years) and Medicare TJA (age ≥65 years)-in May 2020.

Review of Burkhart and DeBeer's (2000) article on traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repair: Where have we taken the concept of glenoid bone loss in 2023?

This classic discusses the original publication by Burkhart and DeBeer "Traumatic Glenohumeral Bone Defects and Their Relationship to Failure of Arthroscopic Bankart Repair" published in 2000 in Arthroscopy. At that time, the authors sought to understand the reasons behind the failure of arthroscopic soft tissue repair. Based on their findings, the authors introduced the concept of the inverted pear glenoid and engaging Hill-Sachs lesion which is now part of the orthopedic lexicon.

Inferior Outcomes for Patients Transferred Between Surgical Stages for Knee Periprosthetic Joint Infection.

Background: Periprosthetic joint infection (PJI) in total knee arthroplasty may result in 2-stage revision surgery. There are limited data describing outcomes when the first stage is completed at an outside hospital and the patient is referred to a tertiary center. We hypothesized that patients have greater success when both surgeries occur at a single center.

NSQIP 30-day outcome measures for below-knee amputations by ICD-10 diagnoses.

Background: The indications for Below-Knee Amputation (BKA) are expansive and etiologic subgroups are not well defined. This analysis uses primary ICD-10 diagnosis codes to stratify patients undergoing BKA, and examines differences in subgroup characteristics and 30-day outcomes.

Methods: We performed a retrospective analysis of patients in the NSQIP database who underwent BKA between 2015 and 2020.

Modifiable lifestyle factors associated with fragility hip fracture: a systematic review and meta-analysis.

Introduction: Among the various hip fracture predictors explored to date, modifiable risk factors warrant special consideration, since they present promising targets for preventative measures. This systematic review and meta-analysis aims to assess various modifiable risk factors.

Material And Methods: We searched four online databases in September 2017.

Rapid Deployment of National Guard Alternative Healthcare Facility With Isolation Unit Capabilities in Response to COVID-19.

At the direction of Governor Phil Scott, the Vermont National Guard rapidly erected a 400-bed alternative healthcare facility field hospital to increase the state's medical capacity early in the COVID-19 pandemic when information was limited and cases were rapidly rising across the country. This case study reviews the preparation and management of the alternative healthcare facility's first COVID-19-positive patient assigned to the 50-bed COVID-19 isolation ward. Despite austere conditions with rudimentary improvements to a nonstandard facility, the ad hoc team composed entirely of members of the Vermont National Guard successfully oversaw patient care from admission to discharge while maintaining a zero-percent transmission rate to staff.

Leveraging Combat Casualty Reporting in the Afghan National Army Special Operations Command for Evidence-Based Changes in the ANASOC School of Excellence.

The Afghan National Army Special Operations Command (ANASOC) uses several documents for casualty reporting. By analyzing these documents from a period of March to December 2018, the authors demonstrate the predominance of gunshot fatalities within ANASOC at approximately 63% of combat deaths and a high rate of prehospital death at approximately 97% of combat deaths. The data also demonstrate relatively few cases of long-term disability from ANASOC soldiers wounded in action.

Medical Screening of a Repatriated Afghan National Army Special Operations Command Prisoner of War.

The Combined Joint Special Operations Task Force-Afghanistan (CJSOTF-A) Surgeon partnered with the Afghan National Army Special Operations Command (ANASOC) Surgeon to complete medical screening of a repatriated ANASOC soldier following a 2019 combined raid on a Taliban prison that freed 35 prisoners of war (POWs). This article discusses the presentation and management of the ANASOC POW while also providing a literature review of common pathologies within the POW population. The purpose of this document is to address a unique aspect of military medicine in the expectation that future military providers are prepared to receive repatriated soldiers and prepared to care for fellow prisoners should they themselves become captured.

Effects of intra-articular corticosteroid injections on lumbar trabecular density.

Purpose: To determine the effect of intra-articular corticosteroid injections on lumbar spine trabecular density.

Materials And Methods: This retrospective study was IRB-approved and HIPAA-compliant. We identified 50 patients (26 F, 24 M, mean age 69 ± 14 years) who had undergone at least three medium or large joint corticosteroid injections using insoluble corticosteroids and a subsequent non-contrast abdominal CT within 5 years of the first injection.

Mechanical Forces Experienced by Simulated Patients Evacuated During Dismounted Military Movement in Mountainous Terrain.

Background: Given a denied or resource-limited area of operations, when air medical evacuation would require extended delay, should dismounted movement through difficult terrain dissuade an attempt of immediate ground evacuation? Understanding the magnitude of external forces during dismounted movement would inform planning in such circumstances.

Objectives: We assessed the mechanical impact experienced during dismounted evacuation from mountainous terrain. We also describe a protocol using a portable accelerometer to evaluate evacuation.

Urinary creatine and methylamine excretion following 4 x 5 g x day(-1) or 20 x 1 g x day(-1) of creatine monohydrate for 5 days.

In this study, we examined the effect of two creatine monohydrate supplementation regimes on 24-h urinary creatine and methylamine excretion. Nine male participants completed two trials, separated by 6 weeks. Participants ingested 4 x 5 g x day(-1) creatine monohydrate for 5 days in one trial and 20 x 1 g x day(-1) for 5 days in the other.

Innovative surveillance methods for rapid detection of disease outbreaks and bioterrorism: results of an interagency workshop on health indicator surveillance.

A system designed to rapidly identify an infectious disease outbreak or bioterrorism attack and provide important demographic and geographic information is lacking in most health departments nationwide. The Department of Defense Global Emerging Infections System sponsored a meeting and workshop in May 2000 in which participants discussed prototype systems and developed recommendations for new surveillance systems. The authors provide a summary of the group's findings, including expectations and recommendations for new surveillance systems.

The motilin antagonist ANQ-11125 blocks motilide-induced contractions in vitro in the rabbit.

Studies on the physiological role of motilin, and more recently, on the relationship between motilin and erythromycin A, have been hampered by the lack of antagonists. We now have discovered such a compound. ANQ-11125 displaces motilin bound to an homogenate of rabbit antral smooth muscle tissue.

D-amino acid and alanine scans of the bioactive portion of porcine motilin.

A recent systematic study of porcine motilin fragments has clearly shown that biological activity resides in the amino-terminal end. The amino-terminal tetradecapeptide retains more than 90% of the potency of the full molecule. We now examined the effect of replacement of residues 1 through 11 by either their D-isomer or by alanine in [Leu13]pMOT(1-14).

Synthesis and in vitro evaluation of [Leu13]porcine motilin fragments.

Several peptide fragments representing N-terminal, C-terminal, and internal sequences of [Leu13]porcine motilin ([Leu13]pMOT) were synthesized using Fmoc solid phase methodology. Peptides were assayed for motilin receptor binding activity in a rabbit antrum smooth muscle preparation and for stimulation of contractile activity in segments of rabbit duodenum. In vitro activity was directly correlated with motilin receptor binding affinity for all [Leu13]pMOT fragments examined.

Capillary zone electrophoresis studies of motilin peptides. Effects of charge, hydrophobicity, secondary structure and length.

Motilin is a gut hormone, which is involved in gastrointestinal motility. Capillary electrophoresis studies were made on 24 peptides that are N-terminal, C-terminal or internal fragments of motilin. The isoelectric point, total charge and hydrophobicity were calculated for all of the peptides.

Chiral high-performance liquid chromatography of aromatic cyclic dipeptides using cyclodextrin stationary phases.

A series of enantiomers of cyclic and linear dipeptides containing aromatic amino acids was prepared and chromatographed on beta- and gamma-cyclodextrin (CD) columns. The retention times, separation factor alpha and resolution values were calculated. The relevance of the distance of the chiral center from the phenyl ring for chiral resolution was studied.

Solution structures of alpha-conotoxin G1 determined by two-dimensional NMR spectroscopy.

Two-dimensional NMR data have been used to generate solution structures of alpha-conotoxin G1, a potent peptide antagonist of the acetylcholine receptor. Structural information was obtained in the form of proton-proton internuclear distance constraints, and initial structures were produced with a distance geometry algorithm. Energetically more favorable structures were generated by using the distance geometry structures as input for a constrained energy minimization program.

High-performance liquid chromatographic separation of peptide and amino acid stereoisomers.

Several high-performance liquid chromatographic (HPLC) methods are described for separation of peptide stereoisomers which are not well resolved by traditional reversed-phase chromatography. These chiral HPLC methods include investigations with a beta-cyclodextrin column, a Pirkle D-Phenyl Glycine column and a Chiral-Pak WH column. A method based on derivatization of dipeptides with a chiral reagent, N-acetyl-L-cysteine and o-phthalaldehyde, is also discussed.