Publications by authors named "Sarah E Lindsay"
Article Synopsis
- Posterior spinal instrumented fusion (PSIF) is a surgical treatment for spinal deformities in adolescents but results in a loss of motion in the spine.
- A study with focus groups and surveys of 18 adolescents who underwent PSIF identified common themes around difficulties in physical activities, with 56% reporting issues with bending and twisting, and 44% with hunching while sitting.
- The findings suggest that these patients experience significant stiffness after the procedure, impacting their daily tasks like self-care and chores, especially those with a more distal last instrumented vertebra.
Background: Available codes in the ICD-10 do not accurately reflect soft tissue sarcoma diagnoses, and this can result in an underrepresentation of soft tissue sarcoma in databases. The National VA Database provides a unique opportunity for soft tissue sarcoma investigation because of the availability of all clinical results and pathology reports. In the setting of soft tissue sarcoma, natural language processing (NLP) has the potential to be applied to clinical documents such as pathology reports to identify soft tissue sarcoma independent of ICD codes, allowing sarcoma researchers to build more comprehensive databases capable of answering a myriad of research questions.
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- The study aimed to explore whether using enoxaparin after surgery impacts the likelihood of needing additional surgery for nonunion in patients who had intramedullary nailing for tibial midshaft fractures.
- Utilizing a retrospective cohort design, researchers analyzed data from the PearlDiver national database, focusing on patients treated between 2015 and 2020 who required revision surgery.
- Findings revealed that enoxaparin use was linked to higher nonunion rates for certain fracture types, indicating it may influence postoperative outcomes.
Background: While individual risk factors, including chronic corticosteroid use, alcohol abuse, and smoking, are implicated in osteonecrosis of the femoral head (ONFH), the degree to which multiple risk factors increase risk is unknown. This study aimed to: (1) identify the demographic characteristics of patients who have ONFH; (2) quantify the effects of individual risk factors on ONFH development; (3) quantify the effects of combined risk factors on ONFH development; and (4) determine the prognostic implications of combined risk factors on ONFH development.
Methods: This was a retrospective cohort study.
Article Synopsis
- * A pilot study involving 13 adults with PASC symptoms explored the impact of 9 months of daily growth hormone (GH) injections on various health measures and self-reported outcomes, such as fatigue and quality of life.
- * Results showed significant improvement in fatigue and mood-related scores, but no significant changes were observed in cognition, body composition, physical performance, or GH secretion levels after treatment.
Objective: To determine if patients that develop lingering neurologic symptoms of fatigue and "brain fog" after initial recovery from coronavirus disease 2019 (COVID-19) have persistent low growth hormone (GH) secretion as seen in other conditions with similar symptom etiology.
Design: In this case-control observational pilot study, patients reporting lingering neurologic post-acute sequelae of SARS-CoV-2 (PASC, n = 10) symptoms at least 6 months after initial infection were compared to patients that recovered from COVID-19 without lingering symptoms (non-PASC, n = 13). We compared basic blood chemistry and select metabolites, lipids, hormones, inflammatory markers, and vitamins between groups.
Community Water Fluoridation and Rate of Pediatric Fractures.
J Am Acad Orthop Surg Glob Res Rev
October 2023
Article Synopsis
- The study aimed to investigate the relationship between community water fluoridation and fracture risk in children, testing the hypothesis that there is no connection between water fluoride levels and fracture rates.
- Data from the CDC and PearlDiver database were analyzed, revealing positive correlations between state fluoridation levels and various types of fractures, especially in states with higher fluoridation levels.
- The findings suggest a link between increased water fluoridation and higher rates of certain fractures in children, highlighting the need for further research on fluoride's impact on bone health in young populations.
Article Synopsis
- Surgical treatment for spinal infections like vertebral osteomyelitis is becoming less reliant on aggressive debridement, with a study exploring the effectiveness of posterior instrumentation alone.
- A review of 27 patients showed that this method led to no recurrent deep infections in most cases, with 70% able to walk independently after surgery.
- The findings suggest that combining long-segment fusion with antibiotics can successfully manage spinal infections without the need for formal debridement, improving patient outcomes for those with related neurological issues.
Background: Pin migration is a common complication associated with closed reduced and percutaneous pinning (CRPP) of supracondylar humerus fractures (SCHF) in children. Though this complication occurs frequently, little work has been done to elicit circumstances surrounding this complication. The purpose of this study was to evaluate patients with SCHF treated with percutaneous pins who needed to return to the operating room for pin removal.
View Article and Find Full Text PDFUnsustainable spending and unsatisfactory outcomes have prompted a reanalysis of healthcare policy towards value. Several strategies have been proposed as part of this effort including cost sharing plans to shift costs to patients and gain-sharing models to shift risk to health systems. The patient perspective is rarely elicited in policy formation despite efforts to increase patient-centered care.
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- The study is a retrospective analysis aimed at understanding the impact of NSAIDs and COX-2 inhibitors on complications like pseudoarthrosis following spinal fusion surgery in patients aged 50 to 85.
- It found that among 178,758 patients, those using NSAIDs and COX-2 inhibitors had higher rates of pseudarthrosis, hardware failures, and required revision surgeries compared to those who did not use these medications.
- Specifically, 13.2% of patients filled NSAID prescriptions and 2.95% filled COX-2 prescriptions, with both groups showing statistically significant complications linked to their usage.
Article Synopsis
- The study aims to compare different methods of estimating blood loss during open pelvic and acetabular surgeries by examining surgeon-estimated blood loss (EBL) alongside two calculation formulas (Gross and HB).
- Conducted as a retrospective cohort study with data from 710 patients who had pelvic or acetabular fracture surgeries from 2008 to 2018 at an academic trauma center, the research found that 27% of patients needed blood transfusions.
- Overall, there was significant discordance between surgeons' EBL and calculated blood loss methods, particularly at high blood loss levels, emphasizing the need for better quantification methods in orthopedic trauma surgeries.
Article Synopsis
- - Idiopathic toe walking (ITW) affects children and can be distressing, with little known about its natural progression and treatment timing, leading researchers to use the Patient-Reported Outcomes Measurement Information System (PROMIS) to gather insights from patients and their families.
- - A study analyzed data from 45 children aged 5 to 17 diagnosed with ITW, revealing that most PROMIS scores were reported by patients, with average scores showing varying levels of mobility, peer relationships, and pain interference.
- - Results indicated a significant negative correlation between gait velocity and peer relationship scores, while parents reported children as having lower mobility scores, highlighting the differing perspectives of children and their caregivers regarding the impact of ITW.
Background: Distal radius buckle fractures (DRBFx) represent nearly half of the pediatric wrist injuries. DRBFx are stable injury patterns that can typically be successfully managed with brief immobilization. The purpose of this study was to evaluate opinions and preferences of pediatric orthopaedic specialists regarding the management of DRBFx.
View Article and Find Full Text PDFCase: A 5-year-old previously healthy girl sustained a left proximal humerus fracture after a fall from a trampoline. The injury was initially treated nonoperatively, but during routine follow-up, the patient was found to have a previously unrecognized bony erosion at the fracture site. Workup was negative for neoplasm but instead demonstrated Salmonella osteomyelitis.
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- An 18-year-old patient exhibited severe symptoms of osteogenesis imperfecta (OI), including frequent fractures, short stature, and abnormal limb structure coupled with unusual radiographic signs.
- Genetic testing revealed two significant mutations: one in the IFITM5 gene and another in the CREB3L1 gene.
- This case illustrates a rare skeletal presentation tied to the IFITM5 mutation, contributing to a unique understanding of severe OI cases.
Objectives: To collect and present the recently published methods of quantifying blood loss (BL) in orthopaedic trauma.
Data Sources: A systematic review of English-language literature in PubMed, Cochrane Library, and Scopus databases was conducted according to the PRISMA guidelines on articles describing the methods of determining BL in orthopaedic trauma published since 2010.
Study Selection: English, full-text, peer-reviewed articles documenting intraoperative BL in an adult patient population undergoing orthopaedic trauma surgery were eligible for inclusion.
Case: A 68-year-old woman with a history of stage IIIC (T3bN1bM0) melanoma with metastases to her right axilla status after 10 cycles of nivolumab presented with right shoulder pain. Radiographs showed a progressive erosive glenohumeral joint lesion. The workup was negative for metastasis and infection.
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- Biofilm-associated infections in orthopedic surgery can lead to severe clinical complications and challenges in diagnosis, often resulting in ineffective antibiotic treatments due to bacteria's protective structures.
- Researchers explored the effects of a compound called MnTE-2-PyP, which is known to scavenge reactive species and modify the redox state, in treating these infections.
- In tests on a mouse model, combining MnTE-2-PyP with antibiotics significantly reduced bacterial counts in infected bone compared to antibiotics alone, suggesting that managing the redox environment can enhance antibiotic efficacy against biofilm-related infections.
Background: The purpose of this systematic review was to determine the metrics used to assess outcomes after treatment for carpal tunnel syndrome.
Methods: We performed a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines of level I and II randomized controlled trials of treatment for carpal tunnel syndrome. We searched the PubMed/MEDLINE electronic database for studies on treatment of carpal tunnel syndrome from January 2008 to January 2018.
Article Synopsis
- The research highlights a significant underrepresentation of obstetrical complications in clinical trials, with only 1.9% (4,276) of the 332,417 studies on ClinicalTrials.gov focusing on obstetrics, despite affecting over a third of women worldwide.* -
- The study analyzes various factors related to trial outcomes, specifically examining the impact of funding sources (industry, U.S. government, academic) and trial features on early discontinuation and results reporting.* -
- Results indicate that obstetrical trials are more likely to be discontinued early compared to non-obstetrical trials, with a greater risk factor identified for these trials and a steady annual increase in obstetrical trial registrations over time.*
Value-based health care models such as bundled payments and accountable care organizations can penalize health systems and physicians for excess costs leading to low-value care. Health systems can minimize these extra costs by constraining diagnostic (eg, magnetic resonance imaging utilization) or treatment options with debatable necessity in the setting of clinical equipoise. Instead of restricting more expensive treatments, it is plausible that health systems could instead recoup the extra costs of these treatments by charging patients supplementary out-of-pocket charges (cost sharing).
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- - The study investigated how much patients want to be involved in decision-making for treating musculoskeletal conditions in orthopaedic surgery.
- - Out of 115 surveyed patients, most preferred a "semipassive" role in decisions, wanting more involvement in scheduling surgeries but less in technical aspects like incision sizes.
- - The findings indicated that younger and more educated patients tended to seek more involvement, while those on Medicare preferred a more passive approach.
Article Synopsis
- The core idea of value-based health care emphasizes high-quality, patient-centered care that aims to improve health outcomes while reducing costs.
- Collaborative decision-making frameworks have been created to enhance patient involvement in their care preferences, but the existing model tends to prioritize population health over individual needs.
- The text underscores the necessity of integrating patient preferences into decision-making processes and introduces a conceptual framework that accounts for these individual preferences when assessing value in health care.
Rationale: Former smoking history and chronic obstructive pulmonary disease (COPD) are potential risk factors for osteoporosis and fractures. Under existing guidelines for osteoporosis screening, women are included but men are not, and only current smoking is considered.
Objectives: To demonstrate the impact of COPD and smoking history on the risk of osteoporosis and vertebral fracture in men and women.