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19 results on '"Hymes, Robert A."'

2. Does Topical Vancomycin Powder Use in Fracture Surgery Change Bacteriology and Antibiotic Susceptibilities? An Analysis of the VANCO Trial

Author

Joshi, Manjari, O'Toole, Robert V., Carlini, Anthony R., Gary, Joshua L., Obremskey, William T., Murray, Clinton K., Gaski, Greg, Reid, J. Spence, Degani, Yasmin, Taylor, Tara J., Collins, Susan C., Huang, Yanjie, Whiting, Paul S., Patterson, Joseph T., Lee, Olivia C., Castillo, Renan C., Bosse, Michael J., Hsu, Joseph R., Karunakar, Madhav A., Kempton, Laurence B., Seymour, Rachel B., Sims, Stephen H., Churchill, Christine, Carroll, Eben, Goodman, James Brett, Holden, Martha B., Gardner, Michael J., Miller, Anna N., Spraggs-Hughes, Amanda, Brennan, Michael L., Weaver, Michael J., Rivera, Jessica C., Kimmel, Joseph E., Reilly, Rachel M., Zura, Robert D., Howes, Cameron, Mir, Hassan, Schmidt, Andrew H., Wagstrom, Emily A., Westberg, Jerald R., McKinley, Todd O., Natoli, Roman M., Sorkin, Anthony, Virkus, Walter, Hill, Lauren C., Hymes, Robert A., Holzman, Michael, Malekzadeh, A. Stephen, Schulman, Jeff E., Schwartzbach, Cary C., Krause, Peter C., Choo, Andrew, Boutte, Sterling, Frisch, H. Michael, Kaufman, Adam M., Large, Thomas M., LeCroy, C. Michael, Smith, Christopher S., Horne, Andrea, LeBrun, Christopher T., Nascone, Jason W., O'Hara, Nathan N., Sciadini, Marcus F., Slobogean, Gerard P., Howe, Andrea L., Rudnicki, Joshua S., Evans, Andrew R., Sietsema, Debra L., Stawicki, Stanislaw P., Wojda, Thomas R., Bishop, Julius A., Rehman, Saqib, Caroom, Cyrus, Ly, Thuan V., Sheridan, Elizabeth, Haller, Justin M., Bergin, Patrick F., Bhanat, Eldrin, Graves, Matt L., Jones, LaRita C., Morellato, John, Spitler, Clay A., Teague, David, Ertl, William, Moloney, Gele B., Weinlein, John C., Zelle, Boris A., Agarwal, Animesh, Karia, Ravi A., Sathy, Ashoke, Sanders, Drew, Weiss, David B., Yarboro, Seth R., Lester-Ballard, Veronica, McVey, Eric D., Firoozabadi, Reza, Simske, Natasha M., Siy, Alexander B., Attum, Basem, Burgos, Eduardo J., Gajari, Vamshi, Rodriguez-Buitrago, Andres, Sethi, Manish K., Trochez, Karen M., and Allen, Lauren E.

Published
2024
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3. Comparative Analysis of Supplemental Medial Buttress Plate Fixation for High-Energy Displaced Femoral Neck Fractures in Young Adults

Author

Collinge, Cory A., Harris, Payton, Sagi, H. Claude, Rodriguez-Buitrago, Andres, Beltran, Michael J., Mitchell, Phillip M., Mir, Hassan R., Lebus, George F., Tornetta, Paul, de la Fuente, Guadalupe, Archdeacon, Michael, Gardner, Michael, Cannada, Lisa K., Streufert, Ben, Robinette, Patton, O'Neill, David, Olszewski, Nathan, Sems, Andrew, Jeray, Kyle, Cardin Poza, Stefano, Tanner, Stephanie, Avilucea, Frank, Schumaier, Adam, Ketz, John, Hedgecock, Jon, Coles, Chad, Trask, Kelly, Macdonald, Shelley, Scolaro, John, Bustillo, David, Crist, Brett D., Horner, Kevin, Bergin, Patrick, Miles, Daniel T., Spitler, Clay, Ahn, Jaimo, Bram, Joshua T., Morris, Tyler, Hsu, Joseph, Buck, J. Stewart, Schmidt, Andrew, Westberg, J.R., Tejwani, Nirmal, Mehta, Devan, Virkus, Walter, Harrington, Justin, Weber, Timothy, Flint, Kathy, Mullis, Brian, Lancaster, Alex, Liporace, Frank, Adams, Don, Horwitz, Daniel, Yaacobi, Eyal, Hymes, Robert, Kilcoyne, Kelly, Cannada, Lisa K., and Lusk, Dominic

Abstract

Supplemental Digital Content is Available in the Text.

Published
2023
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4. Buboes in Thirteenth-Century China: Evidence from Chinese Medical Writings

Author

Hymes, Robert

Abstract

Abstract:In a previous contribution to The Medieval Globe, I proposed the hypothesis that certain epidemics reported in association with the Mongol invasion of China and adjacent states during the thirteenth century and after were plague, and perhaps the first historically recorded manifestation of the Second Pandemic. This article supports that hypothesis using evidence largely from Chinese medical texts of the eleventh through the eighteenth centuries, to show that these epidemics in North Chinese cities directly followed Mongol sieges, as reported by the thirteenth-century physician Li Gao (who witnessed one of them). In turn, they were followed (within twenty-five to fifty years) by the appearance of a brand new symptom in Chinese medical texts: a large purulent sore, called by a name almost new to Chinese medical discourse and entirely new in discourses on epidemic: geda, which I argue was the label applied to the bubo of plague. I show further that Li Gao's description of the treatments attempted by doctors during the siege epidemic of 1232, in the Jin-dynasty capital Kaifeng, strongly imply that the doctors were treating such large purulent sores; and that two of Li Gao's students were leaders in introducing the term geda to epidemic discourse in the decades that followed. What distinguished the response of Chinese physicians to plague from the response of their later European counterparts, I conclude, was that they largely registered its presence by incorporating a new symptom into older epidemic categories rather than by seeing it as a new disease. In a foreword and afterword I frame my work in the context of Monica H. green's recent ambitious and highly persuasive picture of thirteenth-and fourteenth-century plague as a many-branched global phenomenon.

Published
2022

5. Aqueous skin antisepsis before surgical fixation of open fractures (Aqueous-PREP): a multiple-period, cluster-randomised, crossover trial

Author

Slobogean, Gerard P., Sprague, Sheila, Wells, Jeffrey L., Bhandari, Mohit, Harris, Anthony D., Mullins, C. Daniel, Thabane, Lehana, Wood, Amber, Della Rocca, Gregory J., Hebden, Joan N., Jeray, Kyle J., Marchand, Lucas S., O'Hara, Lyndsay M., Zura, Robert D., Lee, Christopher, Patterson, Joseph T., Gardner, Michael J., Blasman, Jenna, Davies, Jonah, Liang, Stephen, Taljaard, Monica, Devereaux, PJ, Guyatt, Gordon, Heels-Ansdell, Diane, Marvel, Debra, Palmer, Jana E., Friedrich, Jeff, O'Hara, Nathan N., Grissom, Frances, Gitajn, I. Leah, Morshed, Saam, O'Toole, Robert V., Petrisor, Bradley, Mossuto, Franca, Joshi, Manjari G., D'Alleyrand, Jean-Claude G., Fowler, Justin, Rivera, Jessica C., Talbot, Max, Pogorzelski, David, Dodds, Shannon, Li, Silvia, Del Fabbro, Gina, Szasz, Olivia Paige, Bzovsky, Sofia, McKay, Paula, Minea, Alexandra, Murphy, Kevin, Howe, Andrea L., Demyanovich, Haley K., Hoskins, Wayne, Medeiros, Michelle, Polk, Genevieve, Kettering, Eric, Mahal, Nirmen, Eglseder, Andrew, Johnson, Aaron, Langhammer, Christopher, Lebrun, Christopher, Nascone, Jason, Pensy, Raymond, Pollak, Andrew, Sciadini, Marcus, Degani, Yasmin, Phipps, Heather, Hempen, Eric, Johal, Herman, Ristevski, Bill, Williams, Dale, Denkers, Matthew, Rajaratnam, Krishan, Al-Asiri, Jamal, Gallant, Jodi L., Pusztai, Kaitlyn, MacRae, Sarah, Renaud, Sara, Adams, John D., Beckish, Michael L., Bray, Christopher C., Brown, Timothy R., Cross, Andrew W., Dew, Timothy, Faucher, Gregory K., Gurich Jr, Richard W., Lazarus, David E., Millon, S. John, Moody, M. Christian, Palmer, M. Jason, Porter, Scott E., Schaller, Thomas M., Sridhar, Michael S., Sanders, John L., Rudisill Jr, L. Edwin, Garitty, Michael J., Poole, Andrew S., Sims, Michael L., Walker, Clark M., Carlisle, Robert, Hofer, Erin A., Huggins, Brandon, Hunter, Michael, Marshall, William, Ray, Shea B., Smith, Cory, Altman, Kyle M., Pichiotino, Erin R., Quirion, Julia C., Loeffler, Markus F., Cole, Austin A., Maltz, Ethan J., Parker, Wesley, Ramsey, T. Bennett, Burnikel, Alex, Colello, Michael, Stewart, Russell, Wise, Jeremy, Anderson, Matthew, Eskew, Joshua, Judkins, Benjamin, Miller, James M., Tanner, Stephanie L., Snider, Rebecca G., Townsend, Christine E., Pham, Kayla H., Martin, Abigail, Robertson, Emily, Bray, Emily, Sykes, J. Wilson, Yoder, Krystina, Conner, Kelsey, Abbott, Harper, Natoli, Roman M., McKinley, Todd O., Virkus, Walter W., Sorkin, Anthony T., Szatkowski, Jan P., Mullis, Brian H., Jang, Yohan, Lopas, Luke A., Hill, Lauren C., Fentz, Courteney L., Diaz, Maricela M., Brown, Krista, Garst, Katelyn M., Denari, Emma W., Osborn, Patrick, Pierrie, Sarah N., Kessler, Bradley, Herrera, Maria, Miclau, Theodore, Marmor, Meir T., Matityahu, Amir, McClellan, R. Trigg, Shearer, David, Toogood, Paul, Ding, Anthony, Murali, Jothi, El Naga, Ashraf, Tangtiphaiboontana, Jennifer, Belaye, Tigist, Berhaneselase, Eleni, Pokhvashchev, Dmitry, Obremskey, William T., Jahangir, Amir Alex, Sethi, Manish, Boyce, Robert, Stinner, Daniel J., Mitchell, Phillip P., Trochez, Karen, Rodriguez, Elsa, Pritchett, Charles, Hogan, Natalie, Fidel Moreno, A., Hagen, Jennifer E., Patrick, Matthew, Vlasak, Richard, Krupko, Thomas, Talerico, Michael, Horodyski, Marybeth, Pazik, Marissa, Lossada-Soto, Elizabeth, Gary, Joshua L., Warner, Stephen J., Munz, John W., Choo, Andrew M., Achor, Timothy S., Routt, Milton L. “Chip”, Kutzler, Michael, Boutte, Sterling, Warth, Ryan J., Prayson, Michael J., Venkatarayappa, Indresh, Horne, Brandon, Jerele, Jennifer, Clark, Linda, Boulton, Christina, Lowe, Jason, Ruth, John T., Askam, Brad, Seach, Andrea, Cruz, Alejandro, Featherston, Breanna, Carlson, Robin, Romero, Iliana, Zarif, Isaac, Dehghan, Niloofar, McKee, Michael, Jones, Clifford B., Sietsema, Debra L., Williams, Alyse, Dykes, Tayler, Guerra-Farfan, Ernesto, Tomas-Hernandez, Jordi, Teixidor-Serra, Jordi, Molero-Garcia, Vicente, Selga-Marsa, Jordi, Porcel-Vazquez, Juan Antonio, Andres-Peiro, Jose Vicente, Esteban-Feliu, Ignacio, Vidal-Tarrason, Nuria, Serracanta, Jordi, Nuñez-Camarena, Jorge, del Mar Villar-Casares, Maria, Mestre-Torres, Jaume, Lalueza-Broto, Pilar, Moreira-Borim, Felipe, Garcia-Sanchez, Yaiza, Marcano-Fernández, Francesc, Martínez-Carreres, Laia, Martí-Garín, David, Serrano-Sanz, Jorge, Sánchez-Fernández, Joel, Sanz-Molero, Matsuyama, Carballo, Alejandro, Pelfort, Xavier, Acerboni-Flores, Francesc, Alavedra-Massana, Anna, Anglada-Torres, Neus, Berenguer, Alexandre, Cámara-Cabrera, Jaume, Caparros-García, Ariadna, Fillat-Gomà, Ferran, Fuentes-López, Ruben, Garcia-Rodriguez, Ramona, Gimeno-Calavia, Nuria, Martínez-Álvarez, Marta, Martínez-Grau, Patricia, Pellejero-García, Raúl, Ràfols-Perramon, Ona, Peñalver, Juan Manuel, Salomó Domènech, Mònica, Soler-Cano, Albert, Velasco-Barrera, Aldo, Yela-Verdú, Christian, Bueno-Ruiz, Mercedes, Sánchez-Palomino, Estrella, Andriola, Vito, Molina-Corbacho, Matilde, Maldonado-Sotoca, Yeray, Gasset-Teixidor, Alfons, Blasco-Moreu, Jorge, Fernández-Poch, Núria, Rodoreda-Puigdemasa, Josep, Verdaguer-Figuerola, Arnau, Cueva-Sevieri, Heber Enrique, Garcia-Gimenez, Santiago, Viskontas, Darius G., Apostle, Kelly L., Boyer, Dory S., Moola, Farhad O., Perey, Bertrand H., Stone, Trevor B., Lemke, H. Michael, Spicer, Ella, Payne, Kyrsten, Hymes, Robert A., Schwartzbach, Cary C., Schulman, Jeff E., Malekzadeh, A. Stephen, Holzman, Michael A., Gaski, Greg E., Wills, Jonathan, Pilson, Holly, Carroll, Eben A., Halvorson, Jason J., Babcock, Sharon, Goodman, J. Brett, Holden, Martha B., Williams, Wendy, Hill, Taylor, Brotherton, Ariel, Romeo, Nicholas M., Vallier, Heather A., Vergon, Anna, Higgins, Thomas F., Haller, Justin M., Rothberg, David L., Olsen, Zachary M., McGowan, Abby V., Hill, Sophia, Dauk, Morgan K., Bergin, Patrick F., Russell, George V., Graves, Matthew L., Morellato, John, McGee, Sheketha L., Bhanat, Eldrin L., Yener, Ugur, Khanna, Rajinder, Nehete, Priyanka, Potter, David, VanDemark III, Robert, Seabold, Kyle, Staudenmier, Nicholas, Coe, Marcus, Dwyer, Kevin, Mullin, Devin S., Chockbengboun, Theresa A., DePalo Sr., Peter A., Phelps, Kevin, Bosse, Michael, Karunakar, Madhav, Kempton, Laurence, Sims, Stephen, Hsu, Joseph, Seymour, Rachel, Churchill, Christine, Mayfield, Ada, Sweeney, Juliette, Jaeblon, Todd, Beer, Robert, Bauer, Brent, Meredith, Sean, Talwar, Sneh, Domes, Christopher M., Gage, Mark J., Reilly, Rachel M., Paniagua, Ariana, Dupree, JaNell, Weaver, Michael J., von Keudell, Arvind G., Sagona, Abigail E., Mehta, Samir, Donegan, Derek, Horan, Annamarie, Dooley, Mary, Heng, Marilyn, Harris, Mitchel B., Lhowe, David W., Esposito, John G., Alnasser, Ahmad, Shannon, Steven F., Scott, Alesha N., Clinch, Bobbi, Weber, Becky, Beltran, Michael J., Archdeacon, Michael T., Sagi, Henry Claude, Wyrick, John D., Le, Theodore Toan, Laughlin, Richard T., Thomson, Cameron G., Hasselfeld, Kimberly, Lin, Carol A., Vrahas, Mark S., Moon, Charles N., Little, Milton T., Marecek, Geoffrey S., Dubuclet, Denice M., Scolaro, John A., Learned, James R., Lim, Philip K., Demas, Susan, Amirhekmat, Arya, and Dela Cruz, Yan Marco

Abstract

Chlorhexidine skin antisepsis is frequently recommended for most surgical procedures; however, it is unclear if these recommendations should apply to surgery involving traumatic contaminated wounds where povidone-iodine has previously been preferred. We aimed to compare the effect of aqueous 10% povidone-iodine versus aqueous 4% chlorhexidine gluconate on the risk of surgical site infection in patients who required surgery for an open fracture.

Published
2022
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7. Early Advanced Weight-Bearing After Periarticular Fractures: A Randomized Trial Comparing Antigravity Treadmill Therapy Versus Standard of Care

Author

Stinner, Daniel J., Rivera, Jessica C., Smith, Christopher S., Weiss, David B., Hymes, Robert A., Matuszewski, Paul E., Gary, Joshua L., Morshed, Saam, Schmidt, Andrew H., Wilken, Jason M., Archer, Kristin R., Bailey, Lane, Kleihege, Jacquelyn, McLaughlin, Kevin H., Thompson, Richard E., Chung, Suna, Remenapp, Craig, MacKenzie, Ellen J., and Reider, Lisa

Abstract

Supplemental Digital Content is Available in the Text.

Published
2022
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8. Defendant-juror similarity and mock juror judgments.

Author

Kerr, Norbert L., Hymes, Robert W., Anderson, Alonzo B., and Weathers, James E.

Subjects
Jury members -- Beliefs, opinions and attitudes, Criminals -- Beliefs, opinions and attitudes
Published
1995

9. The impact of COVID-19 restrictions on participant enrollment in the PREPARE trial

Author

Pogorzelski, David, McKay, Paula, Weaver, Michael J., Jaeblon, Todd, Hymes, Robert A., Gaski, Greg E., Fraifogl, Joanne, Ahn, James S., Bzovsky, Sofia, Slobogean, Gerard, Sprague, Sheila, Gardner, Michael J., Blasman, Jenna, Davies, Jonah, Liang, Stephen, Taljaard, Monica, Slobogean, Gerard P., Sprague, Sheila, Wells, Jeffrey, Bhandari, Mohit, Slobogean, Gerard P., Bhandari, Mohit, Sprague, Sheila, Harris, Anthony D., Mullins, C. Daniel, Thabane, Lehana, Wells, Jeffrey, Wood, Amber, Della Rocca, Gregory J., Harris, Anthony D., Hebden, Joan, Jeray, Kyle J., Marchand, Lucas S., O'Hara, Lyndsay M., Zura, Robert, Lee, Christopher, Patterson, Joseph, Devereaux, P.J., Guyatt, Gordon H., Thabane, Lehana, Heels-Ansdell, Diane, Marvel, Debra, Palmer, Jana, Wells, Jeffrey, Friedrich, Jeff, Mullins, C. Daniel, O'Hara, Nathan N., Grissom, Ms Frances, Della Rocca, Gregory J., Gitajn, I. Leah, Jeray, Kyle J., Morshed, Saam, O'Toole, Robert V., Petrisor, Bradley A., Mossuto, Franca, Harris, Anthony D., Joshi, Manjari G., D'Alleyrand, Jean-Claude, Fowler, Justin, Rivera, Jessica, Talbot, Max, Sprague, Sheila, Bhandari, Mohit, Pogorzelski, David, Dodds, Shannon, Li, Silvia, Rojas, Alejandra, Del Fabbro, Gina, Szasz, Olivia Paige, Heels-Ansdell, Diane, McKay, Paula, Minea, Alexandra, Murphy, Kevin, Slobogean, Gerard P., O'Hara, Nathan N., Howe, Andrea, Demyanovich, Haley, Mullins, C. Daniel, Medeiros, Michelle, Polk, Genevieve, Kettering, Eric, Mahal, Nirmen, O'Toole, Robert V., D'Alleyrand, Jean-Claude, Eglseder, Andrew, Johnson, Aaron, Langhammer, Christopher, Lebrun, Christopher, Nascone, Jason, Pensy, Raymond, Pollak, Andrew, Sciadini, Marcus, Slobogean, Gerard P., Degani, Yasmin, Demyanovich, Haley K., Howe, Andrea, O'Hara, Nathan N., Phipps, Heather, Hempen, Eric, Holler, Christine, Petrisor, Brad A., Johal, Herman, Ristevski, Bill, Williams, Dale, Denkers, Matthew, Rajaratnam, Krishan, Al-Asiri, Jamal, Gallant, Jodi, Pusztai, Kaitlyn, MacRae, Sarah, Renaud, Sara, Jeray, Kyle J., Adams, John D., Beckish, Michael L., Bray, Christopher C., Brown, Timothy R., Cross, Andrew W., Dew, Timothy, Faucher, Gregory K., Gurich, Richard W., Lazarus, David E., Millon, S. John, Moody, M. Christian, Palmer, M. Jason, Porter, Scott E., Schaller, Thomas M., Sridhar, Michael S., Sanders, John L., Rudisill, L. Edwin, Garitty, Michael J., Poole, Andrew S., Sims, Michael L., Walker, Clark M., Carlisle, Robert, Hofer, Erin A., Huggins, Brandon, Hunter, Michael, Marshall, William, Ray, Shea B., Smith, Cory, Altman, Kyle M., Pichiotino, Erin, Quirion, Julia C., Loeffler, Markus F., Pichiotino, Erin R., Cole, Austin A., Maltz, Ethan J., Parker, Wesley, Ramsey, T. Bennett, Burnikel, Alex, Colello, Michael, Stewart, Russell, Wise, Jeremy, Anderson, Matthew, Eskew, Joshua, Judkins, Benjamin, Miller, James M., Tanner, Stephanie L., Snider, Rebecca G., Townsend, Christine E., Pham, Kayla H., Martin, Abigail, Robertson, Emily, Bray, Emily, Sykes, J. Wilson, Yoder, Krystina, Conner, Kelsey, Abbott, Harper, Natoli, Roman M., McKinley, Todd O., Virkus, Walter W., Sorkin, Anthony T., Szatkowski, Jan P., Mullis, Brian H., Jang, Yohan, Lopas, Luke A., Hill, Lauren C., Fentz, Courteney L., Diaz, Maricela M., Brown, Krista, Garst, Katelyn M., Denari, Emma W., Osborn, Patrick, Fowler, Justin, Pierrie, Sarah, Herrera, Maria, Morshed, Saam, Miclau, Theodore, Marmor, Meir, Matityahu, Amir, McClellan, R. Trigg, Shearer, David, Toogood, Paul, Ding, Anthony, Murali, Jothi, El Naga, Ashraf, Tangtiphaiboontana, Jennifer, Belaye, Tigist, Berhaneselase, Eleni, Pokhvashchev, Dmitry, Obremskey, William T., Jahangir, Amir Alex, Sethi, Manish, Boyce, Robert, Stinner, Daniel J., Mitchell, Phillip, Trochez, Karen, Rodriguez, Elsa, Pritchett, Charles, Hogan, Natalie, Moreno, A. Fidel, Hagen, Jennifer E., Patrick, Matthew, Vlasak, Richard, Krupko, Thomas, Talerico, Michael, Horodyski, Marybeth, Pazik, Marissa, Lossada-Soto, Elizabeth, Gary, Joshua L., Warner, Stephen J., Munz, John W., Choo, Andrew M., Achor, Timothy S., Routt, Milton L. Chip, Kutzler, Michael, Boutte, Sterling, Warth, Ryan J., Prayson, Michael, Venkatarayappa, Indresh, Horne, Brandon, Jerele, Jennifer, Clark, Linda, Boulton, Christina, Lowe, Jason, Ruth, John T., Askam, Brad, Seach, Andrea, Cruz, Alejandro, Featherston, Breanna, Carlson, Robin, Romero, Iliana, Zarif, Isaac, Dehghan, Niloofar, McKee, Michael, Jones, Clifford B., Sietsema, Debra L., Williams, Alyse, Dykes, Tayler, Guerra-Farfan, Ernesto, Tomas-Hernandez, Jordi, Teixidor-Serra, Jordi, Molero-Garcia, Vicente, Selga-Marsa, Jordi, Porcel-Vazquez, Juan Antonio, Andres-Peiro, Jose Vicente, Esteban-Feliu, Ignacio, Vidal-Tarrason, Nuria, Serracanta, Jordi, Nuñez-Camarena, Jorge, Mar Villar-Casares, Maria del, Mestre-Torres, Jaume, Lalueza-Broto, Pilar, Moreira-Borim, Felipe, Garcia-Sanchez, Yaiza, Marcano-Fernández, Francesc, Martínez-Carreres, Laia, Martí-Garín, David, Serrano-Sanz, Jorge, Sánchez-Fernández, Joel, Sanz-Molero, Matsuyama, Carballo, Alejandro, Pelfort, Xavier, Acerboni-Flores, Francesc, Alavedra-Massana, Anna, Anglada-Torres, Neus, Berenguer, Alexandre, Cámara-Cabrera, Jaume, Caparros-García, Ariadna, Fillat-Gomà, Ferran, Fuentes-López, Ruben, Garcia-Rodriguez, Ramona, Gimeno-Calavia, Nuria, Martínez-Álvarez, Marta, Martínez-Grau, Patricia, Pellejero-García, Raúl, Ràfols-Perramon, Ona, Peñalver, Juan Manuel, Domènech, Mònica Salomó, Soler-Cano, Albert, Velasco-Barrera, Aldo, Yela-Verdú, Christian, Bueno-Ruiz, Mercedes, Sánchez-Palomino, Estrella, Andriola, Vito, Molina-Corbacho, Matilde, Maldonado-Sotoca, Yeray, Gasset-Teixidor, Alfons, Blasco-Moreu, Jorge, Fernández-Poch, Núria, Rodoreda-Puigdemasa, Josep, Verdaguer-Figuerola, Arnau, Cueva-Sevieri, Heber Enrique, Garcia-Gimenez, Santiago, Viskontas, Darius G., Apostle, Kelly L., Boyer, Dory S., Moola, Farhad O., Perey, Bertrand H., Stone, Trevor B., Lemke, H. Michael, Spicer, Ella, Payne, Kyrsten, Hymes, Robert A., Schwartzbach, Cary C., Schulman, Jeff E., Malekzadeh, A. Stephen, Holzman, Michael A., Gaski, Greg E., Wills, Jonathan, Pilson, Holly, Carroll, Eben A., Halvorson, Jason J., Babcock, Sharon, Goodman, J. Brett, Holden, Martha B., Williams, Wendy, Hill, Taylor, Brotherton, Ariel, Romeo, Nicholas M., Vallier, Heather A., Vergon, Anna, Higgins, Thomas F., Haller, Justin M., Rothberg, David L., Marchand, Lucas S., Olsen, Zachary M., McGowan, Abby V., Hill, Sophia, Dauk, Morgan K., Bergin, Patrick F., Russell, George V., Graves, Matthew L., Morellato, John, McGee, Sheketha L., Bhanat, Eldrin L., Yener, Ugur, Khanna, Rajinder, Nehete, Priyanka, Potter, David, VanDemark, Robert, Seabold, Kyle, Staudenmier, Nicholas, Gitajn, I. Leah, Coe, Marcus, Dwyer, Kevin, Mullin, Devin S., Chockbengboun, Theresa A., DePalo, Peter A., Phelps, Kevin, Bosse, Michael, Karunakar, Madhav, Kempton, Laurence, Sims, Stephen, Hsu, Joseph, Seymour, Rachel, Churchill, Christine, Mayfield, Ada, Sweeney, Juliette, Jaeblon, Todd, Beer, Robert, Demyanovich, Haley K., Bauer, Brent, Meredith, Sean, Talwar, Sneh, Domes, Christopher M., Gage, Mark J., Reilly, Rachel M., Paniagua, Ariana, Dupree, JaNell, Weaver, Michael J., von Keudell, Arvind G., Sagona, Abigail E., Mehta, Samir, Donegan, Derek, Horan, Annamarie, Dooley, Mary, Heng, Marilyn, Harris, Mitchel B., Lhowe, David W., Esposito, John G., Alnasser, Ahmad, Shannon, Steven F., Scott, Alesha N., Clinch, Bobbi, Weber, Becky, Beltran, Michael J., Archdeacon, Michael T., Sagi, Henry Claude, Wyrick, John D., Le, Theodore Toan, Laughlin, Richard T., Thomson, Cameron G., Hasselfeld, Kimberly, Lin, Carol A., Vrahas, Mark S., Moon, Charles N., Little, Milton T., Marecek, Geoffrey S., Dubuclet, Denice M., Scolaro, John A., Learned, James R., Lim, Philip K., Demas, Susan, Amirhekmat, Arya, and Cruz, Yan Marco Dela

Abstract

At the initiation of the COVID-19 pandemic, restrictions forced researchers to decide whether to continue their ongoing clinical trials. The PREPARE (Pragmatic Randomized Trial Evaluating Pre-Operative Alcohol Skin Solutions in Fractured Extremities) trial is a pragmatic cluster-randomized crossover trial in patients with open and closed fractures. PREPARE was enrolling over 200 participants per month at the initiation of the pandemic. We aim to describe how the COVID-19 research restrictions affected participant enrollment.

Published
2022
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11. Intramedullary Nailing of Open Tibial Fractures: Provisional Plate Fixation

Author

Ludwig, Meryl, Hymes, Robert A., Schulman, Jeff, Pitta, Michael, and Ramsey, Lolita

Abstract

Tibia fracture is the most common type of long bone fracture, and intramedullary nailing is the preferred treatment. In open fractures, a provisional plate is often used to maintain reduction. It is unknown whether this practice increases the risk of infection or other complications. This study retrospectively compared patients who were treated at a level 1 trauma center with intramedullary nailing of an open tibia fracture. Patients who were included: (1) were 18 years or older; (2) were treated between January 1, 2005, and June 30, 2013; (3) had an open fracture of the tibia; and (4) were treated operatively with intramedullary nailing, with or without provisional plate fixation. Patient sex, history of diabetes, history of smoking, mechanism of injury, and side of injury were analyzed. Postoperative complications included infection, delayed union or non-union, compartment syndrome, and death. After the authors controlled for age, Gustilo-Anderson type, and AO/Orthopaedic Trauma Association classification, they found that provisional plate use did not significantly increase the risk of infection (adjusted odds ratio, 1.64; 95% confidence interval, 0.51–5.32; Tibia fracture is the most common type of long bone fracture, and intramedullary nailing is the preferred treatment. In open fractures, a provisional plate is often used to maintain reduction. It is unknown whether this practice increases the risk of infection or other complications. This study retrospectively compared patients who were treated at a level 1 trauma center with intramedullary nailing of an open tibia fracture. Patients who were included: (1) were 18 years or older; (2) were treated between January 1, 2005, and June 30, 2013; (3) had an open fracture of the tibia; and (4) were treated operatively with intramedullary nailing, with or without provisional plate fixation. Patient sex, history of diabetes, history of smoking, mechanism of injury, and side of injury were analyzed. Postoperative complications included infection, delayed union or non-union, compartment syndrome, and death. After the authors controlled for age, Gustilo-Anderson type, and AO/Orthopaedic Trauma Association classification, they found that provisional plate use did not significantly increase the risk of infection (adjusted odds ratio, 1.64; 95% confidence interval, 0.51–5.32; P=.41) or any other complications (adjusted odds ratio, 1.24; 95% confidence interval, 0.46–3.35; P=.67). In the subgroup of patients who had a provisional plate (n=35), removal of the plate did not significantly decrease the risk of infection (adjusted odds ratio, 0.43; 95% confidence interval, 0.07–2.69; P=.36) or other complications (adjusted odds ratio, 0.55; 95% confidence interval, 0.12–2.46; P=.44). In open tibia fractures treated with intramedullary nailing, provisional plate stabilization, a valuable reduction aid, did not increase the risk of infection or other complications. Because of the small subgroup size, however, definitive conclusions cannot be drawn about removal of these provisional plates. [Orthopedics.2016; 39(5):e931–e936.]

Published
2016
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12. Epilogue: A Hypothesis on the East Asian Beginnings of the Yersinia pestis Polytomy

Author

Hymes, Robert

Abstract

Abstract:The work of Cui et al. (2013) —in both dating the polytomy that produced most existing strains of Yersinia pestis and locating its original home to the Qinghai-Tibet Plateau—offers a genetically derived specific historical proposition for historians of East and Central Asia to investigate from their own sources. The present article offers the hypothesis that the polytomy manifests itself in the Mongol invasion of the Xia state in the Gansu corridor in the early thirteenth century and continues in the Mongols’ expansion into China and other parts of Eurasia. The hypothesis relies to a considerable extent on work of Cao Shuji (1995), but argues for a different means and direction for the spread of plague than either Cao or William McNeill have previously posited.

Published
2015

13. Reversed Contralateral LISS Plate for Vancouver B1 Periprosthetic Femoral Shaft Fractures

Author

Russo, Matthew, Malekzadeh, A. Stephen, Hampton, Chadwick, Hymes, Robert, Schwartzbach, Cary, and Schulman, Jeffrey

Abstract

The authors reviewed all patients treated for periprosthetic femur fractures between March 1, 2007, and January 31, 2010 at the senior author’s institution. Demographic features, mechanism of injury, radiographs, and computed tomography scans were reviewed to determine the type and stability of the femoral implant at the time of injury. All Vancouver B1 fractures were treated with a novel technique that used a contoured distal femoral locking plate intended for the contralateral femur and reversed to accommodate the ipsilateral femoral bow and contour of the proximal femur. Fixation was achieved around the implant with percutaneously placed unicortical and/or bicortical screws. Radiographs were reviewed for fracture healing, malunion, implant failure, and prosthetic loosening. Fifteen patients were identified and underwent the procedure as described. One patient died soon after surgery of complications from a ruptured preexisting esophageal ulcer. Of the remaining 14 patients, the average duration of follow-up was 25 months (range, 6–31 months). Two patients did not achieve union; however, repeat interpretation of the presenting radiographs showed likely misdiagnosed Vancouver B2 fractures. The first patient had late aseptic loosening and underwent revision surgery 22 weeks postoperatively. The other had early loss of fixation that required revision with a long stem prosthesis. Other complications included 1 deep venous thrombosis and 2 superficial wound infections. The infections were successfully treated with a single formal irrigation and debridement, primary closure, and a short course of oral antibiotics. Ultimately, in 86% of patients (12/14), fracture healing occurred with this biologically friendly technique. [The authors reviewed all patients treated for periprosthetic femur fractures between March 1, 2007, and January 31, 2010 at the senior author’s institution. Demographic features, mechanism of injury, radiographs, and computed tomography scans were reviewed to determine the type and stability of the femoral implant at the time of injury. All Vancouver B1 fractures were treated with a novel technique that used a contoured distal femoral locking plate intended for the contralateral femur and reversed to accommodate the ipsilateral femoral bow and contour of the proximal femur. Fixation was achieved around the implant with percutaneously placed unicortical and/or bicortical screws. Radiographs were reviewed for fracture healing, malunion, implant failure, and prosthetic loosening. Fifteen patients were identified and underwent the procedure as described. One patient died soon after surgery of complications from a ruptured preexisting esophageal ulcer. Of the remaining 14 patients, the average duration of follow-up was 25 months (range, 6–31 months). Two patients did not achieve union; however, repeat interpretation of the presenting radiographs showed likely misdiagnosed Vancouver B2 fractures. The first patient had late aseptic loosening and underwent revision surgery 22 weeks postoperatively. The other had early loss of fixation that required revision with a long stem prosthesis. Other complications included 1 deep venous thrombosis and 2 superficial wound infections. The infections were successfully treated with a single formal irrigation and debridement, primary closure, and a short course of oral antibiotics. Ultimately, in 86% of patients (12/14), fracture healing occurred with this biologically friendly technique. [Orthopedics.2015; 38(6):e467–e472.]

Published
2015
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14. Mechanisms of Failure of Locked-Plate Fixation of the Proximal Humerus

Author

Hymes, Robert A., Levine, Matthew J., Schulman, Jeff E., Westbrook, Ryan D., and Li, Jihui

Abstract

Locking plates are the predominant implants used for proximal humerus fractures. Despite a preponderance of good clinical outcomes, failures continue to occur. The purpose of this study was to investigate the failure mechanism of locked proximal humeral plate fixation and its relationship with bone density and screw length.

Published
2013
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16. Implementing stakeholder engagement to explore alternative models of consent: An example from the PREP-IT trials

Author

Pechero, Guillermo, Pfaff, Branden, Rao, Mayank, Pogorzelski, David, McKay, Paula, Spicer, Ella, Howe, Andrea, Demyanovich, Haley K., Sietsema, Debra L., McTague, Michael F., Ramsey, Lolita, Holden, Martha, Rudnicki, Joshua, Wells, Jeff, Medeiros, Michelle, Slobogean, Gerard P., Sprague, Sheila, Slobogean, Gerard P., Sprague, Sheila, Wells, Jeffrey, Bhandari, Mohit, Slobogean, Gerard P., Bhandari, Mohit, Sprague, Sheila, D'Alleyrand, Jean-Claude, Harris, Anthony D., Mullins, Daniel C., Thabane, Lehana, Wells, Jeffrey, Wood, Amber, Della Rocca, Gregory J., Harris, Anthony D., Hebden, Joan, Jeray, Kyle J., Marchand, Lucas, O'Hara, Lyndsay M., Zura, Robert, Gardner, Michael J., Blasman, Jenna, Davies, Jonah, Liang, Stephen, Taljaard, Monica, Devereaux, P.J., Guyatt, Gordon H., Thabane, Lehana, Heels-Ansdell, Diane, Marvel, Debra, Palmer, Jana, Wells, Jeffrey, Friedrich, Jeff, Mullins, Daniel C., O'Hara, Nathan N., Grissom, Ms Frances, Della Rocca, Gregory J., Gitajn, I. Leah, Jeray, Kyle J., Morshed, Saam, O'Toole, Robert V., Petrisor, Bradley A., Camara, Megan, Mossuto, Franca, Harris, Anthony D., Joshi, Manjari G., D'Alleyrand, Jean-Claude, Fowler, Justin, Rivera, Jessica, Talbot, Max, Sprague, Sheila, Bhandari, Mohit, Dodds, Shannon, Garibaldi, Alisha, Li, Silvia, Nguyen, Uyen, Pogorzelski, David, Rojas, Alejandra, Scott, Taryn, Del Fabbro, Gina, Szasz, Olivia Paige, Heels-Ansdell, Diane, McKay, Paula, Slobogean, Gerard P., O'Hara, Nathan N., Howe, Andrea, Rudnicki, Joshua, Demyanovich, Haley, Little, Kelly, Mullins, C. Daniel, Medeiros, Michelle, Kettering, Eric, Hale, Diamond, O'Toole, Robert V., D'Alleyrand, Jean-Claude, Eglseder, Andrew, Johnson, Aaron, Langhammer, Christopher, Lebrun, Christopher, Manson, Theodore, Nascone, Jason, Paryavi, Ebrahim, Pensy, Raymond, Pollak, Andrew, Sciadini, Marcus, Slobogean, Gerard P., Degani, Yasmin, Demyanovich, Haley K., Howe, Andrea, O'Hara, Nathan N., Joseph, Katherine, Rudnicki, Joshua, Camara, Megan, Petrisor, Brad A., Johal, Herman, Ristevski, Bill, Williams, Dale, Denkers, Matthew, Rajaratnam, Krishan, Al-Asiri, Jamal, Leonard, Jordan, Marcano-Fernández, Francesc A., Gallant, Jodi, Persico, Federico, Gjorgjievski, Marko, George, Annie, Natoli, Roman M., Gaski, Greg E., McKinley, Todd O., Virkus, Walter W., Sorkin, Anthony T., Szatkowski, Jan P., Baele, Joseph R., Mullis, Brian H., Hill, Lauren C., Hudgins, Andrea, Osborn, Patrick, Fowler, Justin, Pierrie, Sarah, Martinez, Eric, Kimmel, Joseph, Jeray, Kyle J., Adams, John D., Beckish, Michael L., Bray, Christopher C., Brown, Timothy R., Cross, Andrew W., Dew, Timothy, Faucher, Gregory K., Gurich, Richard W., Lazarus, David E., Millon, S. John, Palmer, M. Jason, Porter, Scott E., Schaller, Thomas M., Sridhar, Michael S., Sanders, John L., Rudisill, L. Edwin, Garitty, Michael J., Poole, Andrew S., Sims, Michael L., Walker, Clark M., Carlisle, Robert M., Hofer, Erin Adams, Huggins, Brandon S., Hunter, Michael D., Marshall, William A., Ray, Shea Bielby, Smith, Cory D., Altman, Kyle M., Bedard, Julia C., Loeffler, Markus F., Pichiotino, Erin R., Cole, Austin A., Maltz, Ethan J., Parker, Wesley, Ramsey, T. Bennett, Burnikel, Alex, Colello, Michael, Stewart, Russell, Wise, Jeremy, Moody, M. Christian, Tanner, Stephanie L., Snider, Rebecca G., Townsend, Christine E., Pham, Kayla H., Martin, Abigail, Robertson, Emily, Morshed, Saam, Miclau, Theodore, Kandemir, Utku, Marmor, Meir, Matityahu, Amir, McClellan, R. Trigg, Meinberg, Eric, Shearer, David, Toogood, Paul, Ding, Anthony, Donohoe, Erin, Murali, Jothi, Belaye, Tigist, Berhaneselase, Eleni, Paul, Alexandra, Garg, Kartik, Gary, Joshua L., Warner, Stephen J., Munz, John W., Choo, Andrew M., Achor, Timothy S., “Chip” Routt, Milton L., Rao, Mayank, Pechero, Guillermo, Miller, Adam, Hagen, Jennifer E., Patrick, Matthew, Vlasak, Richard, Krupko, Thomas, Sadasivan, Kalia, Koenig, Chris, Bailey, Daniel, Wentworth, Daniel, Van, Chi, Schwartz, Justin, Dehghan, Niloofar, Jones, Clifford B., Tracy Watson, J., McKee, Michael, Karim, Ammar, Talerico, Michael, Sietsema, Debra L., Williams, Alyse, Dykes, Tayler, Obremskey, William T., Jahangir, Amir Alex, Sethi, Manish, Boyce, Robert, Stinner, Daniel J., Mitchell, Phillip, Trochez, Karen, Rodriguez, Andres, Gajari, Vamshi, Rodriguez, Elsa, Pritchett, Charles, Boulton, Christina, Lowe, Jason, Wild, Jason, Ruth, John T., Taylor, Michel, Seach, Andrea, Saeed, Sabina, Culbert, Hunter, Cruz, Alejandro, Knapp, Thomas, Hurkett, Colin, Lowney, Maya, Prayson, Michael, Venkatarayappa, Indresh, Horne, Brandon, Jerele, Jennifer, Clark, Linda, Marcano-Fernández, Francesc, Jornet-Gibert, Montsant, Martínez-Carreres, Laia, Martí-Garín, David, Serrano-Sanz, Jorge, Sánchez-Fernández, Joel, Sanz-Molero, Matsuyama, Carballo, Alejandro, Pelfort, Xavier, Acerboni-Flores, Francesc, Alavedra-Massana, Anna, Anglada-Torres, Neus, Berenguer, Alexandre, Cámara-Cabrera, Jaume, Caparros-García, Ariadna, Fillat-Gomà, Ferran, Fuentes-López, Ruben, Garcia-Rodriguez, Ramona, Gimeno-Calavia, Nuria, Graells-Alonso, Guillem, Martínez-Álvarez, Marta, Martínez-Grau, Patricia, Pellejero-García, Raúl, Ràfols-Perramon, Ona, Peñalver, Juan Manuel, Domènech, Mònica Salomó, Soler-Cano, Albert, Velasco-Barrera, Aldo, Yela-Verdú, Christian, Bueno-Ruiz, Mercedes, Sánchez-Palomino, Estrella, Guerra-Farfan, Ernesto, Tomas-Hernandez, Jordi, Teixidor-Serra, Jordi, Molero-Garcia, Vicente, Selga-Marsa, Jordi, Porcel-Vasquez, Juan Antonio, Andres-Peiro, Jose Vicente, Minguell-Monyart, Joan, Garcia-Sanchez, Yaiza, Nuñez-Camarena, Jorge, Tauste-Rubio, Eladia, Gonzalez-Amigo, Marta, Romeo, Nicholas M., Vallier, Heather A., Breslin, Mary A., Fraifogl, Joanne, Wilson, Eleanor S., Wadenpfuhl, Leanne K., Halliday, Paul G., Viskontas, Darius G., Apostle, Kelly L., Boyer, Dory S., Moola, Farhad O., Perey, Bertrand H., Stone, Trevor B., Lemke, H. Michael, Zomar, Mauri, Spicer, Ella, Fan, Chen “Brenda”, Payne, Kyrsten, Phelps, Kevin, Bosse, Michael, Karunakar, Madhav, Kempton, Laurence, Sims, Stephen, Hsu, Joseph, Seymour, Rachel, Churchill, Christine, Bartel, Claire, Mayberry, Robert Miles, Brownrigg, Maggie, Girardi, Cara, Mayfield, Ada, Hymes, Robert A., Schwartzbach, Cary C., Schulman, Jeff E., Malekzadeh, A. Stephen, Holzman, Michael A., Ramsey, Lolita, Ahn, James S., Panjshiri, Farhanaz, Das, Sharmistha, English, Antoinisha D., Haaser, Sharon M., Cuff, Jaslynn A.N., Pilson, Holly, Carroll, Eben A., Halvorson, Jason J., Babcock, Sharon, Goodman, J. Brett, Holden, Martha B., Bullard, Debra, Williams, Wendy, Higgins, Thomas F., Haller, Justin M., Rothberg, David L., Marchand, Lucas S., Neese, Ashley, Russell, Mark, Olsen, Zachary M., Gitajn, I. Leah, Coe, Marcus, Dwyer, Kevin, Mullin, Devin S., Reilly, Clifford A., DePalo, Peter, Hall, Amy E., Heng, Marilyn, Harris, Mitchel B., Smith, R. Malcolm, Lhowe, David W., Esposito, John G., Bansal, Mira, Bergin, Patrick F., Russell, George V., Graves, Matthew L., Morellato, John, Champion, Heather K., Johnson, Leslie N., McGee, Sheketha L., Bhanat, Eldrin L., Mehta, Samir, Donegan, Derek, Ahn, Jaimo, Horan, Annamarie, Dooley, Mary, Kuczinski, Ashley, Iwu, Ashley, Potter, David, VanDemark, Robert, Pfaff, Branden, Hollinsworth, Troy, Weaver, Michael J., von Keudell, Arvind G., McTague, Michael F., Allen, Elizabeth M., Jaeblon, Todd, Beer, Robert, Demyanovich, Haley K., Gage, Mark J., Reilly, Rachel M., and Sparrow, Cindy

Abstract

Cluster randomized crossover trials are often faced with a dilemma when selecting an optimal model of consent, as the traditional model of obtaining informed consent from participant's before initiating any trial related activities may not be suitable. We describe our experience of engaging patient advisors to identify an optimal model of consent for the PREP-IT trials. This paper also examines surrogate measures of success for the selected model of consent.

Published
2021
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17. Effect of Intrawound Vancomycin Powder in Operatively Treated High-risk Tibia Fractures: A Randomized Clinical Trial

Author

O’Toole, Robert V., Joshi, Manjari, Carlini, Anthony R., Murray, Clinton K., Allen, Lauren E., Huang, Yanjie, Scharfstein, Daniel O., O’Hara, Nathan N., Gary, Joshua L., Bosse, Michael J., Castillo, Renan C., Bishop, Julius A., Weaver, Michael J., Firoozabadi, Reza, Hsu, Joseph R., Karunakar, Madhav A., Seymour, Rachel B., Sims, Stephen H., Churchill, Christine, Brennan, Michael L., Gonzales, Gabriela, Reilly, Rachel M., Zura, Robert D., Howes, Cameron R., Mir, Hassan R., Wagstrom, Emily A., Westberg, Jerald, Gaski, Greg E., Kempton, Laurence B., Natoli, Roman M., Sorkin, Anthony T., Virkus, Walter W., Hill, Lauren C., Hymes, Robert A., Holzman, Michael, Malekzadeh, A. Stephen, Schulman, Jeff E., Ramsey, Lolita, Cuff, Jaslynn A. N., Haaser, Sharon, Osgood, Greg M., Shafiq, Babar, Laljani, Vaishali, Lee, Olivia C., Krause, Peter C., Rowe, Cara J., Hilliard, Colette L., Morandi, Massimo Max, Mullins, Angela, Achor, Timothy S., Choo, Andrew M., Munz, John W., Boutte, Sterling J., Vallier, Heather A., Breslin, Mary A., Frisch, H. Michael, Kaufman, Adam M., Large, Thomas M., LeCroy, C. Michael, Riggsbee, Christina, Smith, Christopher S., Crickard, Colin V., Phieffer, Laura S., Sheridan, Elizabeth, Jones, Clifford B., Sietsema, Debra L., Reid, J. Spence, Ringenbach, Kathy, Hayda, Roman, Evans, Andrew R., Crisco, M.J., Rivera, Jessica C., Osborn, Patrick M., Kimmel, Joseph, Stawicki, Stanislaw P., Nwachuku, Chinenye O., Wojda, Thomas R., Rehman, Saqib, Donnelly, Joanne M., Caroom, Cyrus, Jenkins, Mark D., Boulton, Christina L., Costales, Timothy G., LeBrun, Christopher T., Manson, Theodore T., Mascarenhas, Daniel C., Nascone, Jason W., Pollak, Andrew N., Sciadini, Marcus F., Slobogean, Gerard P., Berger, Peter Z., Connelly, Daniel W., Degani, Yasmin, Howe, Andrea L., Marinos, Dimitrius P., Montalvo, Ryan N., Reahl, G. Bradley, Schoonover, Carrie D., Schroder, Lisa K., Vang, Sandy, Bergin, Patrick F., Graves, Matt L., Russell, George V., Spitler, Clay A., Hydrick, Josie M., Teague, David, Ertl, William, Hickerson, Lindsay E., Moloney, Gele B., Weinlein, John C., Zelle, Boris A., Agarwal, Animesh, Karia, Ravi A., Sathy, Ashoke K., Au, Brigham, Maroto, Medardo, Sanders, Drew, Higgins, Thomas F., Haller, Justin M., Rothberg, David L., Weiss, David B., Yarboro, Seth R., McVey, Eric D., Lester-Ballard, Veronica, Goodspeed, David, Lang, Gerald J., Whiting, Paul S., Siy, Alexander B., Obremskey, William T., Jahangir, A. Alex, Attum, Basem, Burgos, Eduardo J., Molina, Cesar S., Rodriguez-Buitrago, Andres, Gajari, Vamshi, Trochez, Karen M., Halvorson, Jason J., Miller, Anna N., Goodman, James Brett, Holden, Martha B., McAndrew, Christopher M., Gardner, Michael J., Ricci, William M., Spraggs-Hughes, Amanda, Collins, Susan C., Taylor, Tara J., and Zadnik, Mary

Abstract

IMPORTANCE: Despite the widespread use of systemic antibiotics to prevent infections in surgically treated patients with fracture, high rates of surgical site infection persist. OBJECTIVE: To examine the effect of intrawound vancomycin powder in reducing deep surgical site infections. DESIGN, SETTING, AND PARTICIPANTS: This open-label randomized clinical trial enrolled adult patients with an operatively treated tibial plateau or pilon fracture who met the criteria for a high risk of infection from January 1, 2015, through June 30, 2017, with 12 months of follow-up (final follow-up assessments completed in April 2018) at 36 US trauma centers. INTERVENTIONS: A standard infection prevention protocol with (n = 481) or without (n = 499) 1000 mg of intrawound vancomycin powder. MAIN OUTCOMES AND MEASURES: The primary outcome was a deep surgical site infection within 182 days of definitive fracture fixation. A post hoc comparison assessed the treatment effect on gram-positive and gram-negative-only infections. Other secondary outcomes included superficial surgical site infection, nonunion, and wound dehiscence. RESULTS: The analysis included 980 patients (mean [SD] age, 45.7 [13.7] years; 617 [63.0%] male) with 91% of the expected person-time of follow-up for the primary outcome. Within 182 days, deep surgical site infection was observed in 29 of 481 patients in the treatment group and 46 of 499 patients in the control group. The time-to-event estimated probability of deep infection by 182 days was 6.4% in the treatment group and 9.8% in the control group (risk difference, –3.4%; 95% CI, –6.9% to 0.1%; P = .06). A post hoc analysis of the effect of treatment on gram-positive (risk difference, –3.7%; 95% CI, –6.7% to –0.8%; P = .02) and gram-negative-only (risk difference, 0.3%; 95% CI, –1.6% to 2.1%; P = .78) infections found that the effect of vancomycin powder was a result of its reduction in gram-positive infections. CONCLUSIONS AND RELEVANCE: Among patients with operatively treated tibial articular fractures at a high risk of infection, intrawound vancomycin powder at the time of definitive fracture fixation reduced the risk of a gram-positive deep surgical site infection, consistent with the activity of vancomycin. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02227446

Published
2021
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18. Managing work flow in high enrolling trials: The development and implementation of a sampling strategy in the PREPARE trial

Author

Pogorzelski, David, Nguyen, Uyen, McKay, Paula, Thabane, Lehana, Camara, Megan, Ramsey, Lolita, Seymour, Rachel, Goodman, J. Brett, McGee, Sheketha, Fraifogl, Joanne, Hudgins, Andrea, Tanner, Stephanie L., Bhandari, Mohit, Slobogean, Gerard P., Sprague, Sheila, Slobogean, Gerard P., Sprague, Sheila, Wells, Jeffrey, Bhandari, Mohit, Slobogean, Gerard P., Bhandari, Mohit, Sprague, Sheila, D'Alleyrand, Jean-Claude, Harris, Anthony D., Mullins, Daniel C., Thabane, Lehana, Wells, Jeffrey, Wood, Amber, Della Rocca, Gregory J., Harris, Anthony D., Hebden, Joan, Jeray, Kyle J., Marchand, Lucas, O'Hara, Lyndsay M., Zura, Robert, Gardner, Michael J., Blasman, Jenna, Davies, Jonah, Liang, Stephen, Taljaard, Monica, Devereaux, P.J., Guyatt, Gordon H., Thabane, Lehana, Heels-Ansdell, Diane, Marvel, Debra, Palmer, Jana, Wells, Jeffrey, Friedrich, Jeff, Mullins, Daniel C., O'Hara, Nathan N., Grissom, Ms. Frances, Della Rocca, Gregory J., Gitajn, I. Leah, Jeray, Kyle J., Morshed, Saam, O'Toole, Robert V., Petrisor, Bradley A., Camara, Megan, Mossuto, Franca, Harris, Anthony D., Joshi, Manjari G., D'Alleyrand, Jean-Claude, Fowler, Justin, Rivera, Jessica, Talbot, Max, Sprague, Sheila, Bhandari, Mohit, Dodds, Shannon, Garibaldi, Alisha, Li, Silvia, Nguyen, Uyen, Pogorzelski, David, Rojas, Alejandra, Scott, Taryn, Del Fabbro, Gina, Szasz, Olivia Paige, Heels-Ansdell, Diane, McKay, Paula, Slobogean, Gerard P., O'Hara, Nathan N., Howe, Andrea, Rudnicki, Joshua, Demyanovich, Haley, Little, Kelly, Mullins, C. Daniel, Medeiros, Michelle, Kettering, Eric, Hale, Diamond, O'Toole, Robert V., D'Alleyrand, Jean-Claude, Eglseder, Andrew, Johnson, Aaron, Langhammer, Christopher, Lebrun, Christopher, Manson, Theodore, Nascone, Jason, Paryavi, Ebrahim, Pensy, Raymond, Pollak, Andrew, Sciadini, Marcus, Slobogean, Gerard P., Degani, Yasmin, Demyanovich, Haley K., Howe, Andrea, O'Hara, Nathan N., Joseph, Katherine, Rudnicki, Joshua, Camara, Megan, Petrisor, Brad A., Johal, Herman, Ristevski, Bill, Williams, Dale, Denkers, Matthew, Rajaratnam, Krishan, Al-Asiri, Jamal, Leonard, Jordan, Marcano-Fernández, Francesc A., Gallant, Jodi, Persico, Federico, Gjorgjievski, Marko, George, Annie, Natoli, Roman M., Gaski, Greg E., McKinley, Todd O., Virkus, Walter W., Sorkin, Anthony T., Szatkowski, Jan P., Baele, Joseph R., Mullis, Brian H., Hill, Lauren C., Hudgins, Andrea, Osborn, Patrick, Fowler, Justin, Pierrie, Sarah, Martinez, Eric, Kimmel, Joseph, Jeray, Kyle J., Adams, John D., Beckish, Michael L., Bray, Christopher C., Brown, Timothy R., Cross, Andrew W., Dew, Timothy, Faucher, Gregory K., Gurich, Richard W., Lazarus, David E., Millon, S. John, Palmer, M. Jason, Porter, Scott E., Schaller, Thomas M., Sridhar, Michael S., Sanders, John L., Rudisill, L. Edwin, Garitty, Michael J., Poole, Andrew S., Sims, Michael L., Walker, Clark M., Carlisle, Robert M., Hofer, Erin Adams, Huggins, Brandon S., Hunter, Michael D., Marshall, William A., Ray, Shea Bielby, Smith, Cory D., Altman, Kyle M., Bedard, Julia C., Loeffler, Markus F., Pichiotino, Erin R., Cole, Austin A., Maltz, Ethan J., Parker, Wesley, Ramsey, T. Bennett, Burnikel, Alex, Colello, Michael, Stewart, Russell, Wise, Jeremy, Moody, M. Christian, Tanner, Stephanie L., Snider, Rebecca G., Townsend, Christine E., Pham, Kayla H., Martin, Abigail, Robertson, Emily, Morshed, Saam, Miclau, Theodore, Kandemir, Utku, Marmor, Meir, Matityahu, Amir, McClellan, R. Trigg, Meinberg, Eric, Shearer, David, Toogood, Paul, Ding, Anthony, Donohue, Erin, Belaye, Tigist, Berhaneselase, Eleni, Paul, Alexandra, Garg, Kartik, Gary, Joshua L., Warner, Stephen J., Munz, John W., Choo, Andrew M., Achor, Timothy S., “Chip” Routt, Milton L., Rao, Mayank, Pechero, Guillermo, Miller, Adam, Hagen, Jennifer E., Patrick, Matthew, Vlasak, Richard, Krupko, Thomas, Sadasivan, Kalia, Koenig, Chris, Bailey, Daniel, Wentworth, Daniel, Van, Chi, Schwartz, Justin, Dehghan, Niloofar, Jones, Clifford B., Watson, J Tracy, McKee, Michael, Karim, Ammar, Talerico, Michael, Sietsema, Debra L., Williams, Alyse, Dykes, Tayler, Obremskey, William T., Jahangir, Amir Alex, Sethi, Manish, Boyce, Robert, Stinner, Daniel J., Mitchell, Phillip, Trochez, Karen, Rodriguez, Andres, Gajari, Vamshi, Rodriguez, Elsa, Pritchett, Charles, Boulton, Christina, Lowe, Jason, Wild, Jason, Ruth, John T., Taylor, Michel, Seach, Andrea, Saeed, Sabina, Culbert, Hunter, Cruz, Alejandro, Knapp, Thomas, Hurkett, Colin, Lowney, Maya, Prayson, Michael, Venkatarayappa, Indresh, Horne, Brandon, Jerele, Jennifer, Clark, Linda, Marcano-Fernández, Francesc, Jornet-Gibert, Montsant, Martínez-Carreres, Laia, Martí-Garín, David, Serrano-Sanz, Jorge, Sánchez-Fernández, Joel, Sanz-Molero, Matsuyama, Carballo, Alejandro, Pelfort, Xavier, Acerboni-Flores, Francesc, Alavedra-Massana, Anna, Anglada-Torres, Neus, Berenguer, Alexandre, Cámara-Cabrera, Jaume, Caparros-García, Ariadna, Fillat-Gomà, Ferran, Fuentes-López, Ruben, Garcia-Rodriguez, Ramona, Gimeno-Calavia, Nuria, Graells-Alonso, Guillem, Martínez-Álvarez, Marta, Martínez-Grau, Patricia, Pellejero-García, Raúl, Ràfols-Perramon, Ona, Peñalver, Juan Manuel, Domènech, Mònica Salomó, Soler-Cano, Albert, Velasco-Barrera, Aldo, Yela-Verdú, Christian, Bueno-Ruiz, Mercedes, Sánchez-Palomino, Estrella, Guerra, Ernesto, García, Yaiza, Romeo, Nicholas M., Vallier, Heather A., Breslin, Mary A., Fraifogl, Joanne, Wilson, Eleanor S., Wadenpfuhl, Leanne K., Halliday, Paul G., Viskontas, Darius G., Apostle, Kelly L., Boyer, Dory S., Moola, Farhad O., Perey, Bertrand H., Stone, Trevor B., Lemke, H. Michael, Zomar, Mauri, Spicer, Ella, Fan, Chen “Brenda”, Payne, Kyrsten, Phelps, Kevin, Bosse, Michael, Karunakar, Madhav, Kempton, Laurence, Sims, Stephen, Hsu, Joseph, Seymour, Rachel, Churchill, Christine, Bartel, Claire, Mayberry, Robert Miles, Brownrigg, Maggie, Girardi, Cara, Mayfield, Ada, Hymes, Robert A., Schwartzbach, Cary C., Schulman, Jeff E., Malekzadeh, A. Stephen, Holzman, Michael A., Ramsey, Lolita, Ahn, James S., Panjshiri, Farhanaz, Das, Sharmistha, English, Antoinisha D., Haaser, Sharon M., Cuff, Jaslynn A.N., Pilson, Holly, Carroll, Eben A., Halvorson, Jason J., Babcock, Sharon, Goodman, J. Brett, Holden, Martha B., Bullard, Debra, Williams, Wendy, Higgins, Thomas F., Haller, Justin M., Rothberg, David L., Neese, Ashley, Russell, Mark, Gitajn, I. Leah, Coe, Marcus, Dwyer, Kevin, Mullin, Devin S., Reilly, Clifford A., DePalo, Peter, Hall, Amy E., Heng, Marilyn, Harris, Mitchel B., Smith, R. Malcolm, Lhowe, David W., Esposito, John G., Bansal, Mira, Bergin, Patrick F., Russell, George V., Graves, Matthew L., Morellato, John, Champion, Heather K., Johnson, Leslie N., McGee, Sheketha L., Bhanat, Eldrin L., Mehta, Samir, Donegan, Derek, Ahn, Jaimo, Horan, Annamarie, Dooley, Mary, Kuczinski, Ashley, Iwu, Ashley, Potter, David, VanDemark, Robert, Pfaff, Branden, Hollinsworth, Troy, Weaver, Michael J., von Keudell, Arvind G., McTague, Michael F., Allen, Elizabeth M., Jaeblon, Todd, Beer, Robert, Demyanovich, Haley K., Gage, Mark J., Reilly, Rachel M., and Sparrow, Cindy

Abstract

Pragmatic trials in comparative effectiveness research assess the effects of different treatment, therapeutic, or healthcare options in clinical practice. They are characterized by broad eligibility criteria and large sample sizes, which can lead to an unmanageable number of participants, increasing the risk of bias and affecting the integrity of the trial. We describe the development of a sampling strategy tool and its use in the PREPARE trial to circumvent the challenge of unmanageable work flow.

Published
2021
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19. Association Between 6-Week Postdischarge Risk Classification and 12-Month Outcomes After Orthopedic Trauma

Author

Castillo, Renan C., Huang, Yanjie, Scharfstein, Daniel, Frey, Katherine, Bosse, Michael J., Pollak, Andrew N., Vallier, Heather A., Archer, Kristin R., Hymes, Robert A., Newcomb, Anna B., MacKenzie, Ellen J., Wegener, Stephen, Hsu, Joseph R., Karunakar, Madhav A., Seymour, Rachel B., Sims, Stephen H., Flores, Eileen, Churchill, Christine, Hak, David J., Henderson, Corey E., Mir, Hassan R., Chan, Daniel S., Shah, Anjan R., Steverson, Barbara, Westberg, Jerald, Gary, Joshua L., Achor, Timothy S., Choo, Andrew, Munz, John W., Porrey, Melissa, Hendrickson, Sarah, Breslin, Mary A., McKinley, Todd O., Gaski, Greg E., Kempton, Laurence B., Sorkin, Anthony T., Virkus, Walter W., Hill, Lauren C., Jones, Clifford B., Sietsema, Debra L., O’Toole, Robert V., Ordonio, Katherine, Howe, Andrea L., Zerhusen, Timothy J., Obremskey, William, Boyce, Robert H., Jahangir, A. Alex, Molina, Cesar S., Sethi, Manish K., Vanston, Susan W., Carroll, Eben A., Drye, Danielle Yemiola, Holden, Martha B., Collins, Susan C., and Wysocki, Elizabeth

Abstract

IMPORTANCE: Numerous studies have demonstrated that long-term outcomes after orthopedic trauma are associated with psychosocial and behavioral health factors evident early in the patient’s recovery. Little is known about how to identify clinically actionable subgroups within this population. OBJECTIVES: To examine whether risk and protective factors measured at 6 weeks after injury could classify individuals into risk clusters and evaluate whether these clusters explain variations in 12-month outcomes. DESIGN, SETTING, AND PARTICIPANTS: A prospective observational study was conducted between July 16, 2013, and January 15, 2016, among 352 patients with severe orthopedic injuries at 6 US level I trauma centers. Statistical analysis was conducted from October 9, 2017, to July 13, 2018. MAIN OUTCOMES AND MEASURES: At 6 weeks after discharge, patients completed standardized measures for 5 risk factors (pain intensity, depression, posttraumatic stress disorder, alcohol abuse, and tobacco use) and 4 protective factors (resilience, social support, self-efficacy for return to usual activity, and self-efficacy for managing the financial demands of recovery). Latent class analysis was used to classify participants into clusters, which were evaluated against measures of function, depression, posttraumatic stress disorder, and self-rated health collected at 12 months. RESULTS: Among the 352 patients (121 women and 231 men; mean [SD] age, 37.6 [12.5] years), latent class analysis identified 6 distinct patient clusters as the optimal solution. For clinical use, these clusters can be collapsed into 4 groups, sorted from low risk and high protection (best) to high risk and low protection (worst). All outcomes worsened across the 4 clinical groupings. Bayesian analysis shows that the mean Short Musculoskeletal Function Assessment dysfunction scores at 12 months differed by 7.8 points (95% CI, 3.0-12.6) between the best and second groups, by 10.3 points (95% CI, 1.6-20.2) between the second and third groups, and by 18.4 points (95% CI, 7.7-28.0) between the third and worst groups. CONCLUSIONS AND RELEVANCE: This study demonstrates that during early recovery, patients with orthopedic trauma can be classified into risk and protective clusters that account for a substantial amount of the variance in 12-month functional and health outcomes. Early screening and classification may allow a personalized approach to postsurgical care that conserves resources and targets appropriate levels of care to more patients.

Published
2019
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