129 results match your criteria: "Blanchfield Army Community Hospital[Affiliation]"

Utilization of Neurophysiological Classification Systems in Determining Interventions for Patients with Carpal Tunnel Syndrome.

Med J (Ft Sam Houst Tex)

December 2021

Director, Clinical Electrophysiology Services, Texas Physical Therapy Specialists, New Braunfels, TX, and Adjunct Professor, US Army-Baylor University Doctoral Program in Physical Therapy, Fort Sam Houston, TX.

Background: Median mononeuropathy at or distal to the wrist, or carpal tunnel syndrome (CTS), is the most common peripheral nerve compression disorder in the upper extremity. Neurophysiological classification systems for patients with CTS have been developed and implemented to provide health care providers an enhanced system of electrophysiological evaluation with a grading scale, so that they may evaluate their patients with CTS within a system that confers relative severity. Electrophysiological data collected within these classification systems includes either nerve conduction studies (NCS), or both NCS and electromyography (EMG) test results.

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Background: Inhaled tobramycin can be used for empiric or definitive therapy of ventilator-associated pneumonia (VAP) in mechanically ventilated patients. This is believed to minimize systemic exposure and potential adverse drug toxicities including acute kidney injury (AKI). However, detectable serum tobramycin concentrations have been reported after inhaled tobramycin therapy with AKI.

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Case: A 57-year-old male automobile mechanic presented with 1 year of atraumatic, bilateral shoulder pain and progressive loss of motion. Three months of physical therapy and nonsteroidal anti-inflammatory medications did not offer pain relief or increase his motion. He opted for right-sided dermal allograft superior capsular reconstruction (SCR) and anterior capsular reconstruction (ACR) with subsequent left-sided SCR and subscapularis repair 3 months later.

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There's No Such Thing as an Educational Emergency: How COVID-19 Influenced Hospital Education.

J Nurses Prof Dev

November 2021

Jennifer E. Wissemann, DNP, RN, CNE, is Nurse Educator, Women's Health Service Line, Blanchfield Army Community Hospital, Fort Campbell, Kentucky.

With the emergence of a global coronavirus pandemic, traditional timelines and methods for staff education were met with significant challenges. Nurse educators, in collaboration with subject matter experts and leadership, needed to overcome obstacles and utilized a variety of resources to quickly create training tailored to nurses' experience and possible new roles during the pandemic, which led the hospital to be prepared for an unprecedented number of inpatient admissions.

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Introduction: The Military Health System serves to globally provide health services and trained medical forces. Military providers possess variable levels of deployment preparedness. The aim of the Clinical Readiness Program is to develop and assess the knowledge, skills, and abilities (KSAs) needed for combat casualty care.

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TREC Screening for WHIM Syndrome.

J Clin Immunol

April 2021

National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.

Purpose: T cell receptor excision circle (TREC) quantification is a recent addition to newborn screening (NBS) programs and is intended to identify infants with severe combined immunodeficiencies (SCID). However, other primary immunodeficiency diseases (PID) have also been identified as the result of TREC screening. We recently reported a newborn with a low TREC level on day 1 of life who was diagnosed with WHIM (warts, hypogammaglobulinemia, infections, myelokathexis) syndrome, a non-SCID primary immunodeficiency caused by mutations in the chemokine receptor CXCR4.

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Purpose: This article prospectively examines the functional outcome measures following management of vascular insult secondary to paediatric supracondylar humerus fractures (SCHFX) using validated outcome measures.

Methods: The three-year, prospective, IRB-approved study consecutively enrolled operative SCHFX patients. Clinical data included presence and symmetry of the radial pulse in injured and uninjured extremities, Doppler examination of non-palpable (NP) pulses and perfusion status of the hand.

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Background: Research has become a key pillar of academic medicine and a cornerstone of residency training; however, there continues to be significant barriers to ensuring research productivity for residents. We implemented a novel tiered team approach which aimed to increase research productivity and promote collaboration during residency training.

Methods: This was a retrospective study that evaluated the implementation of a novel tiered team research approach at a single institution between 2009 and 2013.

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The Burden of Fingertip Trauma on the US Military.

Hand Clin

February 2021

Department of Orthopaedic Surgery, William Beaumont Army Medical Center, 5005 North Piedras Street, El Paso, TX 79902, USA; Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.

Fingertip injuries in the military are common and often hinder the fighting force and support personnel. Injuries range from small subungual hematomas to proximal finger amputations. Treatment modalities are dictated by injury patterns, anatomic considerations, and the need to return to duty.

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Background: A 9-grid scheme has been integrated into the foot and ankle literature to help clinicians and researchers localize osteochondral lesions of the talus (OLTs). We hypothesized that fellowship-trained orthopedic foot and ankle surgeons would have a high rate of intra/inter-observer reliability when localizing OLTs, therefore validating the scheme.

Methods: We queried our institution's foot and ankle radiographic database for magnetic resonance images with OLTs.

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Injury Risk Factors Associated With Weight Training.

J Strength Cond Res

February 2022

U.S. Army Public Health Center, Clinical Public Health and Epidemiology Directorate, Aberdeen Proving Ground, Maryland; and.

Grier, T, Brooks, RD, Solomon, Z, and Jones, BH. Injury risk factors associated with weight training. J Strength Cond Res 36(2): e24-e30, 2022-The purpose of this evaluation was to identify injury risk factors associated with weight training (WT).

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Background: Prolonged exposure therapy (PE) is an evidence-based treatment for posttraumatic stress disorder (PTSD) that is underutilized in the military health system. Standard workshop training in PE may not be sufficient to alter provider behavior, but post-workshop consultation requires significant resources. Therefore, it is important to determine the incremental utility of post-workshop consultation.

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Targeted Assessment and Context-Tailored Implementation of Change Strategies (TACTICS) to increase evidence based psychotherapy in military behavioral health clinics: Design of a cluster-randomized stepped-wedge implementation study.

Contemp Clin Trials

June 2020

National Center for PTSD, Dissemination and Training Division, VA Palo Alto Healthcare System, 795 Willow Rd, Menlo Park, CA, United States of America; Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Rd, Palo Alto, CA 94305, United States of America. Electronic address:

Background: Despite efforts by the U.S. Department of Defense to train behavioral health (BH) providers in evidence-based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD), numerous barriers limit EBP implementation.

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Background: Uterine leiomyoma are implicated in certain adverse pregnancy related outcomes such as postpartum hemorrhage. Large submucosal leiomyoma defined as greater than 5 cm, may have higher complication rates; however, high quality data is limited.

Case: A 44-year-old gravida 4 with history of two full-term vaginal deliveries presented at 40 and 2/7 weeks of gestation with premature rupture of membranes and delivered vaginally a viable female infant complicated by a postpartum hemorrhage due to uterine atony.

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Purpose: To report the return-to-duty rate and surgical outcomes in a military population after mini-open arthroscopic-assisted surgery for femoroacetabular impingement (FAI) in an effort to affirm its efficacy.

Methods: A retrospective review of consecutive active-duty patients receiving mini-open arthroscopic-assisted surgery for FAI between 2007 and 2011 was performed. Patients younger than 18 years, non-active-duty patients, and patients with prior hip surgery were excluded.

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Introduction: Combat-related injuries have declined substantially in recent years as we have transitioned to a low-volume combat casualty flow era. Surgeons must remain actively committed to training for the next engagement to maintain life and limb-saving skills. Soft tissue coverage procedures were imperative to the management of complex lower extremity trauma that occurred during recent conflicts.

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Purpose: Determine the impact of self-citation on external funding for orthopedic fellowship directors.

Methods: The San Francisco Match's website identified directors encompassing 8 subspecialties. The Scopus database identified the number of publications, citations, and -index for each director.

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Background: Particulated juvenile cartilage allograft transfer (PJCAT) is an emerging treatment option for management of osteochondral lesions of the talus (OCLTs). This series reports on outcomes and identifies predictors for success following PJCAT for isolated OCLTs.

Methods: We reviewed 33 consecutive patients who underwent PJCAT by a single surgeon from 2013 to 2017.

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Acute kidney injury (AKI) is associated with high mortality in burn patients. Urinary biomarkers can aid in the prediction of AKI and its consequences, such as death and the need for renal replacement therapy (RRT). The purpose of this study was to investigate a novel methodology for detecting urinary biomarkers, the NephroCheck® Test System, and assess its ability to predict death or the need for RRT in burn patients.

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Background: Although the benefit of primary intramedullary (IM) screw fixation of fifth metatarsal Jones fractures in athletes is clear, limited data support its use in conventional patient populations. This study evaluated radiographic and functional outcomes following primary IM screw fixation in a series of Jones fractures to determine if similar excellent outcomes were achievable.

Methods: We reviewed the data of 32 consecutive patients who underwent Jones fracture primary IM screw fixation by a single surgeon.

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Purpose: Compare intraarticular pressure of the glenohumeral joint in patients with and without shoulder instability after a volume-limited arthrogram.

Materials And Methods: Patients aged 18-45 years with shoulder instability or pain were included. After injecting 10 cc of contrast-mixture, intraarticular pressure was recorded using an arterial-line pressure-transducer connected to a portable monitor.

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Case: Congenital tibiofibular diastasis is a relatively rare form of limb deficiency, characterized by distal tibial tapering, absent ankle mortise, equinovarus foot deformity, and variable lower leg shortening. Treatment described has ranged from various forms of foot centralization with or without leg lengthening to amputation. We describe 2 cases treated in childhood by staged foot centralization by soft-tissue distraction, distal tibiotalar fusion, tibial lengthening, and subsequent limb length discrepancy equalization.

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