The goal of this randomized clinical trial is to determine if administration of Exparel via local infiltration for medial patellofemoral ligament (MPFL) reconstruction procedures in pediatric orthopaedic sports medicine patients provides significant pain relief and decreased narcotic use. The main questions it aims to answer are:
* Does Exparel significantly reduce Visual Analog Scale (VAS) pain scores and pain levels up to one week postoperatively?
* Does Exparel significantly decrease narcotic use (number of pills taken) up to one week postoperatively?
Researchers will compare the pain outcomes and narcotic use of patients who receive Exparel and Marcaine via local infiltration to those of patients who receive only Marcaine via local infiltration for their MPFL reconstruction surgery. The goal is to understand if there is a significant difference in patient pain outcomes and narcotic use outside the first 24 hours postoperatively.
Participants will:
* receive either Exparel + Marcaine intraoperatively or Marcaine only intraoperatively during their MPFL reconstruction surgery
* receive and complete questionnaires at postoperative days 1, 4, and 7 regarding their pain scores, levels, and outcomes, effective pain treatments, overall pain interference, narcotic use (number of pills taken), and overall pain treatment satisfaction
* receive and complete secondary outcome measures of functional and psychological outcomes regarding their MPFL reconstruction surgery at postoperative day 1

开始日期2024-12-01

申办/合作机构

Texas Scottish Rite Hospital for Children

NCT06559137 / Not yet recruiting临床2期IIT

Prospective Evaluation of Post-operative Pain Management Using Peripheral Nerve Blocks in the Pediatric Population

The goal of this randomized clinical trial is to determine if single-shot ropivacaine peripheral nerve blocks (PNB - perineural injections) for anterior cruciate ligament (ACL) reconstruction procedures in pediatric orthopaedic sports medicine patients provides significant pain relief and decreased narcotic use. The main questions it aims to answer are:
* Does ropivacaine significantly reduce Visual Analog Scale (VAS) pain scores and pain levels up to one week postoperatively?
* Does ropivacaine significantly decrease narcotic use (number of pills taken) up to one week postoperatively?
Researchers will compare the pain outcomes and narcotic use of participants who receive a single-shot ropivacaine peripheral nerve block to those of participants who do not receive a single-shot ropivacaine peripheral nerve block for their ACL reconstruction surgery. The goal is to understand if there is a significant difference in participant pain outcomes and narcotic use outside the first 24 hours postoperatively.
Participants will:
* receive either a single-shot ropivacaine peripheral nerve block intraoperatively or no peripheral nerve block during their ACL Quadriceps tendon graft or bone patellar tendon bone graft reconstruction surgery.
* receive and complete questionnaires at postoperative days 1, 4, and 7 regarding their pain scores, levels, and outcomes, effective pain treatments, overall pain interference, narcotic use (number of pills taken), and overall pain treatment satisfaction
* receive and complete secondary outcome measures of functional and psychological outcomes regarding their ACL reconstruction surgery at postoperative day 1

开始日期2024-09-01

申办/合作机构

Texas Scottish Rite Hospital for Children

NCT06048419 / RecruitingN/AIIT

Acceptability and Efficacy of GO MOVE: A Mobile Health Technology for Youth With Unilateral Cerebral Palsy

The goal of this clinical trial is to learn about the acceptability and efficacy of Go Move, a mobile website developed to assist youth with unilateral cerebral palsy and their caregivers with setting goals and selecting exercises and activities to meet the goals. The main question[s] it aims to answer are:
Is Go Move accepted by youth with unilateral cerebral palsy and their caregivers?
Does Go Move support goal attainment for youth with unilateral cerebral palsy?
Participants will set up and participate in a goal-driven home program using the Go Move mobile website. Participants will spend 1 hour and 15 minutes per week for 6 weeks working on their home program and will complete pre-intervention and post-intervention assessments.

开始日期2024-02-20

申办/合作机构

Texas Scottish Rite Hospital for Children

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项与 Texas Scottish Rite Hospital for Children 相关的文献（医药）

2024-10-01·JOURNAL OF HAND SURGERY-AMERICAN VOLUME

Does Preservation of Metacarpophalangeal Joint Vascularity Protect Against Physeal Arrest in Index Finger Pollicization?

Article

作者: Ezaki, Marybeth ; Stutz, Chris ; Reghunathan, Meera ; Hinchcliff, Katharine ; Schneidau, Courtney ; Oishi, Scott N

PURPOSE:

To determine whether preservation of blood supply to the index metacarpophalangeal joint decreases the rate of physeal arrest.

METHODS:

A retrospective review of 41 pollicized digits in 35 patients with 2-year minimum radiographic follow-up was conducted at a single institution. Other complications evaluated included nonunion at the pollicized digit base and clinical instability at the new carpometacarpal joint. Findings were compared to historical controls, which were performed by our group prior to routine identification and sparing of the metacarpophalangeal joint blood supply. No other modifications to surgical technique were made between the previous and current patient cohorts.

RESULTS:

Two pollicized digits in two different patients had radiographic evidence of physeal arrest, one of which was partial and the other complete, for an arrest rate of 4.9%. This was significantly less than the arrest rate in our historical cohort of 24.7% (21 of 85 patients). Five patients did not have radiographic bony union at the base of the index metacarpal, but only one patient had clinical instability at the new carpometacarpal joint.

CONCLUSIONS:

Significantly fewer patients who underwent index finger pollicization with preservation of the metacarpophalangeal joint blood supply went on to develop physeal arrest when compared to patients who underwent pollicization prior to adoption of this technique. This finding suggests that sparing of the physeal blood supply is preventative against proximal phalanx physeal arrest.

TYPE OF STUDY/LEVEL OF EVIDENCE:

Therapeutic IV.

2024-08-08·JOURNAL OF CLINICAL AND EXPERIMENTAL NEUROPSYCHOLOGY

Posttraumatic stress symptoms in recovery from concussion

Article

作者: Doggett, Hannah ; Stokes, Mathew ; Didehbani, Nyaz ; Wilmoth, Kristin ; Bunt, Stephen C. ; Hynan, Linda S. ; Bell, Kathleen R. ; Cullum, C. Munro ; Tamez, Ingrid ; Miller, Shane M.

BACKGROUND:

Previous literature suggests that lingering concussion symptoms may be influenced by psychological factors. The relationship of posttraumatic stress symptoms (PTSS) during recovery with pre-existing/injury related factors and concussion symptomology is not fully understood. Identification of factors contributing to symptoms of posttraumatic stress may provide guidance to improve treatment following concussion.

METHOD:

This study included 287 participants (Male 40.42%, n = 116; Female 59.58%, n = 171) aged 13-75 years diagnosed with a recent concussion at one of the North Texas Concussion Registry (ConTex) specialty concussion clinic sites. Preinjury emotional history, injury related factors, and emotional state at time of initial evaluation were analyzed as predictors of post-traumatic stress symptoms (PCL-5) during recovery.

RESULTS:

Sixty-one percent of participants endorsed at least one PTSS. Correlations were found between initial Sport Concussion Assessment Tool 5^Ⓡ (SCAT5) total emotional symptom severity and screening measures for anxiety (GAD-7; r = .453, p < .001) and depression (PHQ-8; r = .550, p < .001) symptom scores. Of the measures from the initial visit included in the multiple regression model predicting severity of PTSS at follow-up (R² = 0.554, β < .001), three measures predicted PTSS severity: initial SCAT5 total emotional symptom severity (β = 0.565, p < .001), PHQ-8 score (β =.166, p = .009), and GAD-7 score (β = 0.119, p = .044).

CONCLUSIONS:

Symptoms of anxiety and depression along with specific SCAT5 emotional symptoms present at the time of initial evaluation may serve to predict overall level of PTSS and increased risk for PTSS during recovery. PTSS may be another dimension of response to injury and concussion recovery, with a large percentage of individuals endorsing at least one PTSS. Clinicians can utilize brief assessments such as the SCAT5 at the time of initial clinical evaluation to identify those at risk for PTSS following concussion.

2024-03-20·The Journal of bone and joint surgery. American volume

Long-Term Follow-up of Untreated Adult Patients with Spondylothoracic Dysostosis (Jarcho-Levin Syndrome)

Article

作者: Carlo, Simón ; Johnston, Charles E ; Cornier, Alberto Santiago ; Monroig-Rivera, Carlos ; Arciniegas Medina, Norma J ; De Jesús-Rojas, Wilfredo ; Vélez-Bartolomei, Frances ; Ramírez, Norman ; Rosado, Edwin

Background::

Spondylothoracic dysostosis (STD), also known as Jarcho-Levin syndrome (JLS), is a rare autosomal recessive disorder affecting the formation of the spine, characterized by a complete bilateral fusion of the ribs at the costovertebral junction, producing a “crablike” appearance of the thorax. Despite being declared a core indication for a V-osteotomy vertical expandable prosthetic titanium rib (VEPTR) expansion thoracoplasty of the posterior thorax, the natural history of STD in untreated subjects remains poorly documented. In this study, we report radiographic and pulmonary function findings and Patient-Reported Outcomes Measurement Information System (PROMIS) and 24-Item Early Onset Scoliosis Questionnaire (EOSQ-24) scores for untreated adult subjects with STD to gain insights into the natural history.

Methods::

We identified 11 skeletally mature, untreated subjects with STD. Findings on medical evaluation, demographics, radiographic parameters, pulmonary function, genetic testing results, PROMIS measures, and EOSQ-24 scores were assessed.

Results::

Five male and 6 female subjects (mean age, 32.3 years [range, 15 to 70 years]) with a confirmed STD diagnosis based on radiographs and genetic testing were evaluated. Mean body mass index (BMI) was 24.4 kg/m2 (range, 18 to 38.9 kg/m2), and mean thoracic height was 16 cm (range, 12 to 17 cm). Pulmonary function tests (PFTs) showed a mean forced vital capacity (FVC) of 22% of predicted, mean forced expiratory volume in 1 second (FEV1) of 24% of predicted, and FEV1/FVC ratio of 107% of predicted. The mean PROMIS dyspnea score was 40 ± 8 points (range, 27.7 to 52.1 points). The mean total EOSQ-24 score was 77.3 ± 18 points (range, 43.9 to 93.2 points).

Conclusions::

Our study characterizes the natural history of STD in untreated subjects. We confirmed the expected restrictive pattern in pulmonary function, but interestingly, our subjects exhibited better EOSQ scores compared with those reported in neuromuscular populations. PFT results and thoracic height did not correspond to PROMIS and EOSQ scores, questioning the use of those parameters as a surgical indication. We therefore suggest that the STD diagnosis as an absolute indication for VEPTR expansion thoracoplasty surgery be reconsidered.

Level of Evidence::

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

项与 Texas Scottish Rite Hospital for Children 相关的新闻（医药）

2023-12-14

·PRNewswire

The Inner Circle Acknowledges, Wale Charles Abolarin as a Distinguished Healthcare Professional for his contributions to the field of Clinical Informatics Technology

OWINGS MILLS, Md., Dec. 14, 2023 /PRNewswire/ -- Prominently featured in The Inner Circle, Wale Charles Abolarin is acknowledged as a Distinguished Healthcare Professional for his contributions to the field of Clinical Informatics Technology. Dr. Abolarin received his Doctorate of Medicine specializing in Anesthesiology from the Ladoke Akintola University of Technology in 2009. He furthered his education in the United States at the University of South Florida, obtaining a graduate certificate in Health Informatics in 2016 and a Master's degree in Health informatics in 2017. In addition, Dr. Abolarin boasts an impressive array of prestigious certifications in Leadership and Health Information Technology, among them the notable Physician IT Architect Certificate. Touting more than 14 years in the Healthcare, Dr. Abolarin stands at the forefront as the CEO and Chief Medical Informatics Officer of Helix Healthcare Inc. This esteemed institution is not just a provider but a beacon of hope for those with developmental disabilities in Maryland and beyond. Championing the cause of local communities, Dr. Abolarin passionately avers that the mission of Helix Healthcare goes beyond medical care. It's about sculpting an ecosystem where patients and their families can effortlessly avail themselves of equitable healthcare, find promising employment opportunities, access top-notch job training, community development, and harness the power of education through technology. Helix Healthcare is a lifeline, providing indispensable services like Alternative living units and remote support services. Before stepping into his current role, Dr. Abolarin accumulated an expansive range of experiences across various capacities in the medical field. He has held esteemed roles such as Physician Champion, Physician Executive, Physician Advisor, and Physician Informatics Architect. His association with significant institutions includes the McLaren Health Care Corporation, Atos Digital Health Solutions, Midland Memorial Hospital, Texas Scottish Rite Hospital for Children, Our Lady of Lourdes's Memorial Hospital, MedStar Good Samaritan Hospital, and a number of hospitals in Nigeria. Beyond these roles, Dr. Abolarin has provided consultation services to several US hospitals, pioneering multiple informatics projects. These projects, powered by technology, have been meticulously designed to mitigate physician burnout and amplify productivity. In his relentless pursuit of excellence, he is a member of the American College of Healthcare Executives, the American Society of Anesthesiology, and the Nigerian Medical Association. With an unwavering and formidable passion for serving others, Dr. Abolarin has not only achieved immense success but has also set himself apart in the realm of informatics. One of his crowning achievements is his role as the architect behind the sepsis advisor at McLaren Health Care Corporation, an algorithmic powerhouse designed to swiftly diagnose sepsis, thus acting as a bulwark against potential fatalities. As we gaze into the horizon, let it be known that Dr. Abolarin's legacy as a leader isn't just rooted in his unmatched expertise in healthcare or informatics alone. It's his unparalleled versatility and prowess across diverse fields, from healthcare to entrepreneurship, that truly sets him apart from the crowd. Contact: Katherine Green 516-825-5634 [email protected] SOURCE The Inner Circle

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