9 results on '"Natalie A. Low"'
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2. Technique for All-Inside Anterior Cruciate Ligament Reconstruction Using Quadrupled Semitendinosus and Gracilis Autograft
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Natalie A. Lowenstein, B.S., Madison E. Altwies, P.A.-C., Victor Hoang, D.O., Taylor Anthony, B.S., and Elizabeth G. Matzkin, M.D.
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Orthopedic surgery ,RD701-811 - Abstract
Anterior cruciate ligament (ACL) injuries are common to athletes and non-athletes alike. Whereas the literature has historically supported bone–patellar tendon–bone as the gold standard for active patients who elect to undergo ACL reconstruction, other studies have suggested that soft-tissue grafts do not increase the risk of rerupture. Because graft diameter has a direct effect on revision rates, we share a technique for all-inside ACL reconstruction using quadrupled semitendinosus and gracilis autograft that allows for a predictable, robust graft. Reproducible steps of graft harvesting, tunnel preparation, graft passage, and fixation are shared to achieve a robust anatomic reconstruction.
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- 2023
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3. Fragility Functions for Steel Plate Shear Walls
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Natalie A. Low, Nicole M. Baldvins, Jeffery W. Berman, Todd M. Janes, and Laura N. Lowes
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Empirical data ,Engineering ,Geophysics ,Fragility ,Buckling ,business.industry ,Log-normal distribution ,Tearing ,Shear wall ,Probability distribution ,Structural engineering ,Geotechnical Engineering and Engineering Geology ,business - Abstract
Fragility functions are developed to predict the method of repair required for steel plate shear walls damaged due to earthquake loading. The results of previous experimental studies are used to develop empirical relationships between damage states and story drift. Damage states are proposed and linked deterministically with commonly employed methods of repair; these damage states are characterized by parameters such as yielding and tearing of the steel plate and yielding, buckling and fracture of frame members. Lognormal probability distributions are fit to the empirical data and evaluated using standard statistical methods. The results of this effort are families of fragility functions that predict the required method of repair for a damaged wall.
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- 2012
4. Patients with diabetes mellitus experience poorer outcomes after arthroscopic rotator cuff repair
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Eli T. Sayegh, MD, Matthew J. Gooden, MS, Natalie A. Lowenstein, BS, Jamie E. Collins, PhD, and Elizabeth G. Matzkin, MD
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Arthroscopy ,Diabetes mellitus ,Rotator cuff tear ,Rotator cuff repair ,Patient-reported outcome measures ,Shoulder function ,Orthopedic surgery ,RD701-811 ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Hypothesis: The purpose of this study was to identify potential differences using validated clinical outcome instruments between patients with and without diabetes mellitus (DM) after arthroscopic rotator cuff repair (RCR). Methods: Six-hundred eighty-four patients (32 with and 652 without DM) who underwent arthroscopic RCR were prospectively followed using the visual analog pain scale, Simple Shoulder Test, Single Assessment Numeric Evaluation, American Shoulder and Elbow Surgeons score, and Veterans RAND 12-item Health Survey (mental and physical component scores) preoperatively and at 3, 6, 12, and 24 months postoperatively. Results: Patients with DM experienced significantly more pain (P = .0172) and had lower Simple Shoulder Test (P = .0458) and American Shoulder and Elbow Surgeons (P = .0200) scores than patients without DM 6 months after surgery. Although differences between groups are seen at other postoperative time points, none are statistically significant.They also exhibited lower self-rated mental health status at 12 months (P = .0034) and 24 months (P = .0077), as well as lower self-rated physical health status at 12 months (P = .0223) and 24 months (P = .0077). Changes in scores from preoperatively to postoperatively were not different for patients with DM vs. without DM. Conclusion: Patients with DM experience significantly more pain, exhibit significantly poorer shoulder function, and report persistently diminished mental and physical health status compared with their counterparts without DM after undergoing arthroscopic RCR. Although these differences did not reach the minimal clinically important difference, orthopedic surgeons should be cognizant of DM as an outcome-modifying variable when selecting, counseling, and treating patients with rotator cuff tears. Glycemic control should be scrutinized and optimized during the perioperative medical evaluation and ultimately factored into the surgical risk profile and prognosis.
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- 2022
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5. Impact of smoking on patient-reported outcome measures after arthroscopic rotator cuff repair: a 2-year comparative cohort study
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Charles A. Cefalu, MD, Natalie A. Lowenstein, BS, Kirsten D. Garvey, MS, Jamie E. Collins, PhD, and Elizabeth G. Matzkin, MD
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Smoking ,Rotator cuff repair ,Patient-reported outcome measures ,Subjective outcomes ,Shoulder arthroscopy ,Shoulder ,Orthopedic surgery ,RD701-811 ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Background and Hypothesis: Smoking is a well-established risk factor for tendon healing. The purpose of this study was to evaluate the differences in patient-reported outcome measures between smokers and nonsmokers who have undergone arthroscopic rotator cuff repair. It was hypothesized that smokers would have worse self-reported outcomes at 1 and 2 years postoperatively. Methods: A total of 560 consecutive patients who underwent arthroscopic rotator cuff repair were divided into 2 groups: group I (smokers) n = 25 and group II (nonsmokers) n = 535. All participants were administered preoperative and postoperative surveys consisting of the following outcome-measuring tools: (i) visual analog scale, (ii) Veterans Rand 12-Item Health Survey, (iii) American Shoulder and Elbow Surgeons shoulder score, (iv) standard preoperative form consisting of 4 questions regarding their expectations of recovery, (v) Single Assessment Numeric Evaluation shoulder score, and (vi) Simple Shoulder Test. Results: At 1 and 2 years postoperative, nonsmokers reported statistically significant differences in Veterans Rand 12-Item Health Survey mental scores (56.2 vs. 51.9, P = .0162 and 56.3 vs. 49.5, P = .0004, respectively). American Shoulder and Elbow Surgeons Shoulder scores showed no differences until the 2-year mark, at which time nonsmokers reported higher scores than smokers (87.9 vs. 79.0, P = .0212). Single Assessment Numeric Evaluation scores also remained similar up until 2-year follow-up, at which time nonsmokers reported statistically significant improvement (80.0 vs. 68.5, P = .0339). Nonsmokers reported higher Simple Shoulder Test scores at baseline and at 2-year follow-up (43.3 vs. 37.0, P = .0417 and 83.7 vs. 68.1, P = .0046, respectively). Conclusion: At 2 years postoperatively, nonsmokers had significantly higher patient-reported outcome measure scores than smokers. In elective surgery, smoking status should be considered as a risk factor for poorer patient-reported outcomes after arthroscopic rotator cuff repair. However, smokers continue to report a clinical benefit at 2 years postoperatively.
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- 2021
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6. The Murri clinic: A comparative retrospective study of an antenatal clinic developed for Aboriginal and Torres Strait Islander women
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Kristen Gibbons, Sue Kildea, Rebecca Murphy, Helen Stapleton, and Natalie Billy Low
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Program evaluation ,Native Hawaiian or Other Pacific Islander ,Health Services Accessibility ,Pregnancy ,Obstetrics and Gynaecology ,Outpatient clinic ,Cultural Competency ,Evaluation ,Culturally responsive ,education.field_of_study ,Obstetrics and Gynecology ,Prenatal Care ,Continuity of Patient Care ,Model of care ,Patient Satisfaction ,Premature Birth ,Female ,Multi-agency ,medicine.symptom ,Research Article ,Adult ,Outpatient Clinics, Hospital ,Adolescent ,Maternity ,Population ,Prenatal care ,Midwifery ,lcsh:Gynecology and obstetrics ,Indigenous ,Young Adult ,Patient satisfaction ,Nursing ,medicine ,Health Services, Indigenous ,Humans ,Indigenous Australian ,Antenatal ,education ,lcsh:RG1-991 ,Retrospective Studies ,Aboriginal and Torres Strait Islander ,business.industry ,Australia ,Infant, Newborn ,Infant, Low Birth Weight ,Delivery, Obstetric ,Focus group ,Low birth weight ,Apgar Score ,Analgesia, Obstetrical ,business ,Program Evaluation - Abstract
Background Indigenous Australians are a small, widely dispersed population. Regarding childbearing women and infants, inequities in service delivery and culturally unsafe services contribute to significantly poorer outcomes, with a lack of high-level research to guide service redesign. This paper reports on an Evaluation of a specialist (Murri) antenatal clinic for Australian Aboriginal and Torres Strait Islander women. Methods A triangulated mixed method approach generated and analysed data from a range of sources: individual and focus group interviews; surveys; mother and infant audit data; and routinely collected data. A retrospective analysis compared clinical outcomes of women who attended the Murri clinic (n=367) with Indigenous women attending standard care (n=414) provided by the same hospital over the same period. Both services see women of all risk status. Results The majority of women attending the Murri clinic reported high levels of satisfaction, specifically with continuity of carer antenatally. However, disappointment with the lack of continuity during labour/birth and postnatally left some women feeling abandoned and uncared for. Compared to Indigenous women attending standard care, those attending the Murri clinic were statistically less likely to be primiparous or partnered, to experience perineal trauma, to have an epidural and to have a baby admitted to the Neonatal Intensive Care Unit, and were more likely to have a non-instrumental vaginal birth. Multivariate analysis found higher normal birth (spontaneous onset of labour, no epidural, non-instrumental vaginal birth without episiotomy) rates amongst women attending the Murri clinic. Conclusions Significant benefits were associated with attending the Murri clinic. Recommendations for improvement included ongoing cultural competency training for all hospital staff, reducing duplication of services, improving co-ordination and communication between community and tertiary services, and working in partnership with community-based providers. Combining multi-agency resources to increase continuity of carer, culturally responsive care, and capacity building, including creating opportunities for Indigenous employment, education, and training is desirable, but challenging. Empirical evidence from our Evaluation provided the leverage for a multi-agency agreement to progress this goal within our catchment area.
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- 2012
7. Customizing Functional Rehabilitation and Return to Sport in the Female Overhead Athlete
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Stephanie L. Boudreau, P.T., D.P.T., Laura L. Mattes, P.T., D.P.T., O.C.S., Natalie A. Lowenstein, B.S., Elizabeth G. Matzkin, M.D., and Reg B. Wilcox, III, P.T., D.P.T., M.S., O.C.S.
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Sports medicine ,RC1200-1245 - Abstract
Participation of female athletes in sports at all levels continues to grow exponentially, as well as the injuries they experience during play. A literature review does outline return to sport guidelines, yet few studies address the potential need for differences between male and female athletes. This commentary is a review of the literature that outlines various sports that involve both male and female overhead athletes and potential differences in upper-extremity injuries and strengths and weaknesses between sexes. This information proposes the potential need to customize return-to-sport guidelines and screens that include recommendations for overhead female athletes within their specific sport, following both injury as well as surgical intervention. Level of Evidence: V.
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- 2022
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8. Satisfactory Pain Management With Minimal Opioid Use After Arthroscopic Rotator Cuff Repair
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Kirsten D. Garvey, M.S., Natalie A. Lowenstein, B.S., Lauren E. Piana, M.D., Kaetlyn R. Arant, B.A., Yuchiao Chang, Ph.D., and Elizabeth G. Matzkin, M.D.
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Sports medicine ,RC1200-1245 - Abstract
Purpose: To evaluate patient use of opioids following arthroscopic rotator cuff repair, including the number of days and number of pills when used in combination with non-opioid medications and to determine whether patients were satisfied with their pain management and if variables such as age, sex, body mass index, duration of symptoms, anticipation of postoperative pain, preoperative opioid consumption, size of the rotator cuff tear, or anxiety/depression affected pain management. Methods: This was a prospective cohort study of 117 prospectively enrolled patients older than the age of 18 years undergoing primary arthroscopic rotator cuff repair. All patients completed preoperative and 2-week postoperative questionnaires to assess their pain and satisfaction with pain management. Univariate and multivariate analyses were performed to evaluate the association of patient characteristics with satisfaction of pain control and amount/duration of opioids postoperatively. Results: Patients required a median of 18 opioid pain pills or 135 morphine milligram equivalents (interquartiles, 6-35 pills) postoperatively over 6.9 ± 5.1 days. In total, 65% of patients took opioid pain medications for 7 days or fewer. On postoperative day 2, patients reported a VAS pain score of 6.6 ± 2.8 and at the 2-week postoperative visit, mean visual analog scale pain score was 3.5 ± 2.5. Differences in age, sex, body mass index, duration of symptoms, anticipation of postoperative pain, preoperative 2-item Patient Health Questionnaire, 2-item Pain Self-Efficacy Questionnaire, current opioid use, and surgical characteristics had no effect on, or association with, satisfaction with pain management postoperatively. Conclusions: Following arthroscopic rotator cuff repair, patients can achieve satisfactory pain control using a multimodal approach with a median of 18 opioid pills (range 6-35 pills) over 6.9 ± 5.1 days when used in combination with non-opioid pain medications. Overall, 74.4% of patients were satisfied with their postoperative pain management. Level of Evidence: Level II; Prospective cohort study.
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- 2021
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9. Smoking Negatively Effects Patient-Reported Outcomes Following Arthroscopic Partial Meniscectomy
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Nicholas R. Kraus, M.S., Natalie A. Lowenstein, B.S., Kirsten D. Garvey, M.S., and Elizabeth G. Matzkin, M.D.
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Sports medicine ,RC1200-1245 - Abstract
Purpose: To determine whether active smokers have different patient-reported outcomes relative to nonsmokers for pain, function, and overall health at baseline and 1 or 2 years after an arthroscopic partial meniscectomy. Methods: Patients who underwent arthroscopic partial meniscectomy were identified. Demographic data, including smoking status and patient-reported outcome measures (PROMs), were prospectively collected preoperatively and 3 months, 6 months, 1 year, and 2 years postoperatively. Statistical analysis was performed using the mixed-effects model to compare PROMs preoperatively and 1 or 2 years postoperatively between nonsmokers and active smokers. Results: 509 knees undergoing arthroscopic partial meniscectomy were divided into 2 cohorts: group I, nonsmokers (n = 470) and group II, active smokers (n = 39). There were statistically significant baseline differences in PROMs for nonsmokers versus smokers: visual analog scale (VAS), 5.0 ± 0.4 versus 6.3 ± 0.7, respectively (P = .001); Knee Injury and Osteoarthritis Outcome Score (KOOS) Pain scale, 50.3 ± 3.2 versus 42.5± 5.5 (P = .005); KOOS Symptoms scale, 50.0 ± 3.2 versus 43.6 ± 5.4 (P = .019); and Western Ontario and McMaster Universities Arthritis Index (WOMAC) Pain scale, 57.5 ± 3.4 versus 48.2 ± 6.1 (P = .003). There were also statistically significant differences in nonsmokers versus smokers regarding knee function at baseline shown by the KOOS Activites of Daily Living (ADL) scale: (61.1 ± 3.3 versus 53.5 ± 6.1; P = .015). Baseline mental health, as assessed by the Veterans Rand 12-Item Health Survey (VR-12) Mental Health questionnaire, was also statistically different between nonsmokers (55.4 ± 0.8) and smokers (51.5 ± 3.3; P = .020). Importantly, PROMs for pain and function were lower at all time points for smokers. Conclusion: Patients who were active smokers at the time of partial meniscectomy had significantly worse baseline and postoperative PROMs compared with nonsmokers. Changes from baseline for smokers and nonsmokers were relatively consistent between groups 1 and 2 years postoperatively. Smokers will improve a relatively similar amount as nonsmokers after partial meniscectomy, but their overall PROM scores are lower. Level of Evidence: III, retrospective comparative study.
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- 2021
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