Evaluating Failure Rates of Primary Quadriceps Tendon Repairs Across Different Surgical Techniques.

Background: Quadriceps tendon ruptures occur infrequently in the general population. Biomechanical data suggest advantages with the use of suture anchor fixation for major tendon repair. Clinical studies of quadriceps tendon repair have been limited to small case series.

Comparison of neuraminidase inhibiting antibody responses elicited by egg- and cell-derived influenza vaccines.

Unlabelled: Neuraminidase (NA)-specific antibodies contribute to immunity against influenza. While studies have demonstrated increased NA inhibiting (NAI) antibody titers after vaccination with egg-derived inactivated influenza vaccines (eIIV), the response to cell culture-derived (c) IIV has not been reported.

Methods: An immunogenicity sub-study was performed within a clinical trial comparing the effectiveness of egg, cell, and recombinant hemagglutinin (HA)-derived influenza vaccines during the 2018-2019 and 2019-2020 influenza seasons.

Health disparities investigated in a primary care penicillin allergy removal pathway.

Unconfirmed penicillin allergies over time lead to poor health outcomes and increased health-care cost. Health disparities (HD) can create barriers in optimizing penicillin allergy care. The objective was to characterize HDs in our primary care-led amoxicillin challenge (PLAC) delabeling pathway within a universal coverage health care system.

Pernicious Pouch of Problems: A Challenging Case of Massive Hemorrhage Secondary to Jejunal Diverticular Bleeding.

Small bowel (SB) diverticulosis is an uncommon diagnosis and a rare cause of gastrointestinal (GI) bleeding. A particularly rare form of SB diverticular disease, jejunal diverticulosis, is usually discovered due to complications, such as hemorrhage, obstruction, or perforation. Owing in part to its rarity, jejunal diverticular bleeding can be difficult to identify and treat, resulting in increased morbidity and mortality.

Cervical Cancer Screening in the United States Military Health System During the COVID-19 Pandemic.

Introduction During the COVID-19 pandemic, healthcare systems implemented restrictions on in-person appointments to mitigate viral spread among healthcare workers and patients. This study assesses changes in cervical cancer screening (CCS) rates within the United States Military Health System (MHS) during this period. To date, no such data have been reported on COVID-19's effect on CCS within the MHS.

Review of Functional Cranioplasty and Implantable Neurotechnology.

Cranioplasty for secondary reconstruction of cranial defects has historically focused on simply replacing the missing cranial bone to restore cerebral protection and fluid dynamics, but recent innovations have led to the development of customized cranial implants that address both bone and soft tissue deficits while avoiding postoperative complications such as temporal hollowing. In addition, customized cranial implants have incorporated implantable neurotechnology like ventriculostomy shunts, intracranial pressure monitoring devices, and medicine delivery systems within low-profile designs to convert previously "basic" implants into "smart" implants for added functionality. These "smart" implants aim to reduce complications and improve patient outcomes by leveraging the cranial space to house advanced technologies, providing benefits such as real-time biosensing, and treatment of chronic neurological conditions.

Herpes simplex virus presenting as an oropharyngeal mass.

Objectives: Present a clinically challenging case of an immunocompetent 74-year-old male who presented with marked dyspnea and hemoptysis. After the airway was secured, direct laryngoscopy revealed a large, fungating, hemorrhagic mass of the left lateral pharyngeal wall and surrounding structures.

Methods: Chart review of a single patient.

A systematic review on revision total hip arthroplasty employing the direct anterior approach.

Introduction: The increased use of the direct anterior approach (DAA) for primary total hip arthroplasty (THA) has extended to revision THA. This systematic review evaluated studies reporting both the utility and clinical outcomes of revision THA using DAA, focusing on studies comparing revision approaches.

Materials And Methods: A review of the Cochrane Library, EMBASE, and MEDLINE databases identified 577 publications.

Self-Directed Skills Laboratories Increase Emergency Medicine Physician Confidence in High-Acuity, Low-Opportunity Procedures.

Introduction: The critical role of emergency physicians in military settings underscores the necessity for a broad and proficient skill set, especially in life-saving procedures such as thoracostomies, endotracheal intubations, and cricothyrotomies, to maintain combat readiness. The current peacetime phase, however, presents challenges in maintaining these skills because of decreased exposure to high-acuity medical scenarios. This decrease in exposure jeopardizes skills retention among military emergency medicine physicians, highlighted by studies showing a significant decline in performance over time because of reduced practice.

High-Grade B-Cell Lymphoma: An Atypical Mass in the Colon.

Masses in the colon can range from benign to malignant etiologies, with adenocarcinoma being the most common malignancy. Although the most frequently encountered hematologic malignancy in the military population, lymphoma is uncommonly identified during colonoscopy. We present a rare case of an active duty service member with abdominal pain and a large mesenteric mass with extension into the cecum that was a high-grade B-cell lymphoma diagnosed through endoscopy.

ACR Appropriateness Criteria® Altered Mental Status, Coma, Delirium, and Psychosis: 2024 Update.

Altered mental status (AMS) and coma are terms used to describe disorders of arousal and content of consciousness. AMS may account for up to 4% to 10% of chief complaints in the emergency department setting and is a common accompanying symptom for other presentations. AMS is not a diagnosis, but rather a term for symptoms of acute or chronic disordered mentation, including confusion, disorientation, lethargy, drowsiness, somnolence, unresponsiveness, agitation, altered behavior, inattention, hallucinations, delusions, and psychosis.

Eustachian Tube Dysfunction After LeFort 1 Osteotomy Orthognathic Surgery.

The authors present a 24-year-old male with a history of class III occlusal deformity who underwent a maxillary advancement with LeFort I osteotomies. Eighteen months after surgery, he was diagnosed with bothersome Eustachian tube dysfunction (ETD). Anatomical shifts secondary to the LeFort osteotomies required for maxillary advancement result in vector changes of muscles that regulate the function of the Eustachian tube.

Paederus Dermatitis: Two Outbreaks of an Entomologic Disease in Austere Expeditionary Care.

Paederus dermatitis, also known as dermatitis linearis, is an acute cutaneous condition caused by contact with the potent vesicant toxin paederin, produced by endosymbiotic Pseudomonas-like bacteria within Paederus spp. beetles. Paederin is a protein synthesis inhibitor that halts cell division, leading to vesiculation and necrotic breakdown of the epidermis.

Enhancing trauma care in Ukraine amid conflict: A successful implementation of the modified advanced trauma life support course in an active war zone.

Background: Following the 2022 Russian invasion, Ukraine's healthcare system suffered extensive damage, with over 1000 medical facilities destroyed, exacerbating the trauma care crisis. The absence of standardized trauma training left Ukrainian healthcare providers ill-equipped to manage the surge in trauma cases amid conflict. To bridge this gap, we implemented advanced trauma life support (ATLS) courses in Ukraine amid active warfare, aiming to enhance trauma care expertise among healthcare professionals.