The Affordable Care Act and orthopaedic trauma.

The Affordable Care Act has resulted in a dramatic governmental restructuring of the healthcare insurance market and delivery system. Orthopaedic traumatologists must be aware of the law's impact on their clinical practice, finances, and overall business model. This includes the effect of accountable care organizations, the Independent Payment Advisory Board, and the Physician Value-Based Payment Modifier program, as well as the impact of the Affordable Care Act's grace period provision, medical device excise tax, and cuts to funding for the Disproportionate Share Hospital program.

Treating post-traumatic tremor with deep brain stimulation: report of five cases.

Background: Post-traumatic tremor is one of the most common movement disorders resulting from severe head trauma. However, literature regarding successful deep brain stimulation (DBS) treatment is scarce, resulting in ambiguity regarding the optimal lead location. Most cases support the ventral intermediate nucleus, but there is evidence to defend DBS of the zona incerta, ventral oralis anterior/posterior, and/or a combination of these targets.

Health literacy in an orthopaedic trauma patient population: improving patient comprehension with informational intervention.

Objectives: This study aims to evaluate the change in comprehension of diagnoses, treatment plans, and discharge instructions after orthopaedic trauma patients are given an informational document that includes pictorial representations at the time of discharge. It also seeks to determine if the intervention has a greater impact on patients with lower educational backgrounds.

Design: Prospective comparative cohort study.

Appendiceal duplication in children presenting as an appendiceal tumor and as recurrent intussusception.

Duplication of the appendix is a rare condition and is usually an incidental finding during an appendectomy. There have been several cases reported in the literature. Although not usually associated with any discrete pathology, the presenting symptoms can vary but are usually associated with acute appendicitis.

The role of the CXCR4 cell surface chemokine receptor in glioma biology.

CXCR4, a cell surface chemokine receptor, mediates cellular dissemination, invasion, and proliferation in a wide range of cancers including gliomas. It is over-expressed in glioma progenitor cells, and its protein ligand, CXCL12, has been shown to mediate a specific proliferative response in these cells thereby implicating a role for CXCR4 in glioma initiation and renewal. Given the failure of currently employed therapies to meaningfully impact prognosis in patients with high-grade gliomas, the CXCR4-CXCL12 axis represents a novel biologically relevant mechanism that could be specifically targeted for therapy.

The link between texting and motor vehicle collision frequency in the orthopaedic trauma population.

Background: This study will evaluate whether or not texting frequency while driving and/or texting frequency in general are associated with an increased risk of incurring a motor vehicle collision (MVC) resulting in orthopaedic trauma injuries.

Methods: All patients who presented to the Vanderbilt University Medical Center Orthopaedic Trauma Clinic were administered a questionnaire to determine background information, mean phone use, texting frequency, texting frequency while driving, and whether or not the injury was the result of an MVC in which the patient was driving.

Results: 237 questionnaires were collected.

Health literacy in an orthopedic trauma patient population: a cross-sectional survey of patient comprehension.

Objectives: The aim of this study was to evaluate the level of comprehension in an orthopedic trauma patient population regarding injury, surgery, and postoperative instructions and to determine if educational background is associated with inadequate comprehension.

Design: This involved a prospective observational cohort.

Setting: The study was conducted at an Academic Level 1 trauma center.