Kansas Journal of Medicine最新文献

Introduction: The da Vinci^® surgical system has become standard in many specialties. The dual-console system has increased console time for residents during their training. This study evaluated patient outcomes using the single- versus dual-console system in resident training.

Methods: A retrospective case-control study was conducted of patients who underwent various colorectal surgeries using either the single- or dual-console da Vinci^® system. Patient demographics, comorbidities, and outcomes were collected.

Results: Seventy-one patients (54.2%) utilized the single-console and 60 (45.8%) utilized the dual-console. There were no statistically significant differences in patient demographics, procedures performed, conversion to open, ICU admissions, total length of stay, need for blood transfusion, adequacy of surgical margin, number of lymph nodes harvested, anastomotic leak, discharge disposition, or readmission, wound infection, or need for reoperation within 30 days. There was a nonsignificant decrease in operative time with the dual-console system (200.6 vs. 220.2 minutes, p = 0.111).

Conclusions: While this study showed no statistically significant differences between patient outcomes utilizing the single- versus dual-consoles, it showed that it is safe for use in training, and that more research is needed in this area.

Introduction: The purpose of this study was to evaluate quadriceps strength and knee function after anterior cruciate ligament (ACL) reconstruction using a quadriceps tendon bone (QTB) autograft.

Methods: Preliminary data were extracted from an ongoing prospective cohort study in which the operative extremity was compared to non-operative extremity. Patients from 14 to 40 years of age who had an ACL reconstruction with QTB autograft volunteered to have knee assessment including quadriceps isokinetic strength measures and functional knee testing at 6 and 12 months post-operatively. Paired t-tests were conducted to compare post-operative strength and function scores on participants who had minimum one-year post-surgical follow-up.

Results: Patients had a significant recovery of quadriceps strength as determined by isokinetic testing and single leg hop test. For 31 participants, quadriceps strength of the operative leg measured at 60 deg/sec was 63% of the non-operative leg at six months, increasing to 79% at one year (p < 0.001); when measured at 180 deg/sec, these values were 68% at six months, increasing to 82% at one year (p < 0.001). For 30 participants, single leg hop functional scores of the operative leg were 80% of the non-operative leg at six months, increasing to 91% at one year (p < 0.001).

Conclusions: After QTB autograft for ACL reconstruction, there were significant gains in quadriceps strength and knee function from six months to one year post-operative. These findings indicated the QTB is an acceptable ACL reconstruction option.

Introduction: There are approximately 60,000 Traditional Bone Setters (TBS) in India, who have no formal education or training in modern medicine but treat approximately 60% of bone related trauma. This study investigated the history of TBS, why they are so popular, and their methods.

Methods: From a list of TBS from four states in South India, a purposive and convenience sampling method identified participants. One lead TBS from each state was interviewed. With recommendations from these TBS, a total of six participants were interviewed on Zoom^® in their native dialect and these interviews were transcribed into English. The data were analyzed using a constant comparative method which included several iterations to refine common themes and determine counterfactual and specific focal points from each interview.

Results: Six overarching themes emerged: (1) history of traditional bone setters, (2) occupations outside bone setting, (3) training, certification, education, accolades, (4) patient characteristics and success stories, (5) infrastructure and approach to diagnosis/treatment, and (6) limitations of practice, challenges, and social relevance. The history of traditional bone setting is thousands of years old and passed down within families generationally.

Conclusions: In rural India, where a large part of the population lives in poverty and without access to modern medicine, traditional healers provide a much-needed service, often without charge, and consequently, the income is not sufficient without other occupations such as farming. They follow a similar approach to diagnosis and treatment of simple fractures and dislocations as modern medical practitioners. Most would like to share their knowledge and collaborate with ayurvedic and allopathic practitioners and simply want to be respected and supported.

Introduction: There have been widespread concerns about the safety of the COVID-19 vaccines, particularly when it comes to pediatric populations, and it is important to provide information for parents and guardians to make informed decisions. This study sought to identify the adverse events or reactions (AERs) associated with the COVID-19 vaccines in Kansans aged 6 to 17.

Methods: The U.S. Department of Health and Human Services' "Vaccine Adverse Event Reporting System" (VAERS) database was searched from May 11, 2021, to April 30, 2022, for AERs related to COVID-19 vaccines in adolescents ages 6 to 17. Results were grouped by vaccine manufacturer and patient gender.

Results: A total of 159 individuals reported 409 AERS, with an average of 2.6 per person (± 1.7; median = 2; range 1 to 10). Females (n = 95) reported 237 AERs, with an average of 2.5 each (±1.7; median = 2; range 1 to 8), while males (n = 64) reported 172 AERs, with an average of 2.7 each (±1.8; median = 2; range 1 to 8). The most common adverse event associated with Pfizer^® vaccination was syncope/fainting.

Conclusions: COVID-19 vaccines have undergone intensive monitoring and safety regulations since the onset of the coronavirus. With over 591 million doses administered, there was compelling evidence that the COVID-19 vaccines are safe and effective. Informing the public about the potential AERs of the COVID-19 vaccines in children can help to alleviate vaccine hesitancy and strengthen vaccination confidence.