Search

Introduction: The dearth of research investigating the efficacy of virtual Army Combat Fitness Test (ACFT) training programs among female populations necessitates further exploration. This study aims to evaluate the effectiveness of a 12-week ACFT virtual exercise program among female participants., Materials and Methods: Nine female participants (age = 19.7 ± 1.3 years, height = 165.9 ± 4.9 cm, and body mass = 62.7 ± 5.9 kg) volunteered to complete 2 assessment sessions and the 12-week ACFT virtual exercise training program. In session 1, baseline height, body mass, body composition, and ACFT scores were collected. Upon completion of session 1, under supervisory guidance, all participants were scheduled to complete the 12-week exercise training program in-person. The ACFT exercise training program required participants to complete a warmup/cool down and exercise with suspension training straps 4 days per week, 60 minutes for 12 weeks. In session 2, post-assessments of body mass, body composition, and ACFT scores were collected. Statistical analyses were conducted utilizing paired sample t-tests to assess differences between pre- and post-intervention ACFT scores with P ≤ .05. Cohen's d was calculated to quantify the magnitude of the observed effect., Results: Overall mean ACFT pre-intervention scores (487.2 ± 66.5) increased significantly when compared to mean ACFT post-intervention scores (521.6 ± 44.0) (Cohen's d = 0.86, P = .03). No statistical differences were displayed among the individual mean ACFT pre- versus post-intervention scores. A consistent decline in adherence of 3.9% per week ensued from week 1 through week 12., Conclusions: Following the intervention, female participants experienced a significant increase of approximately 7% in their overall ACFT scores, with upward trends observed across all 6 individual ACFT events. These findings suggest that 12-week virtual suspension training can be a valuable tool for enhancing physical fitness and performance among female participants, particularly within the context of military readiness., (© The Association of Military Surgeons of the United States 2025. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.)

Introduction: Femoral nerve injury is a recognized complication of abdominal, pelvic, and orthopedic surgeries. It can also occur due to pelvic fractures, intra-abdominal trauma, and hip injuries. These injuries often result in pain, weakness, and difficulty with ambulation, significantly impacting a patient's quality of life., Case Report: We report the case of a 72-year-old male who developed femoral nerve palsy while exiting a hot tub. The unusual mechanism of injury initially led to a missed diagnosis, delaying appropriate treatment. Following an extensive diagnostic workup, femoral nerve palsy was identified as the cause of his disability. Timely intervention ultimately led to the resolution of his symptoms., Conclusion: This case highlights a novel mechanism of femoral nerve palsy and underscores the importance of prompt diagnosis for optimal outcomes. Clinicians must maintain a high index of suspicion for rare injury mechanisms to avoid delays in treatment., Competing Interests: Conflict of Interest: Nil, (Copyright: © Indian Orthopaedic Research Group.)

Glucagon-like peptide-1 (GLP-1) receptor agonists are medications used to treat type 2 diabetes and may aid in weight loss efforts. The surgical management of patients taking GLP-1 agonists differs from others due to the slowed gastric emptying effects of GLP-1 medications. Patients taking these medications may have a higher risk of pulmonary aspiration during hand surgery than other patients, which affects their presurgical management. This article reviews GLP-1 agonists and their role in diabetes and weight loss, as well as current recommendations for surgical management of patients taking GLP-1 agonists., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Medicare reimbursement trends across multiple surgical subspecialties have been analyzed; however, little has been reported regarding the long-term trends in reimbursement of hand surgery procedures. The aim of this study is to analyze trends in Medicare reimbursement for commonly performed hand surgeries., Methods: Using the Centers for Medicare and Medicaid Services Physician and Other Supplier Public Use File, we determined the 20 hand surgery procedure codes most commonly billed to Medicare in 2016. Reimbursement rates were collected and analyzed for each code from The Physician Fee Schedule Look-Up Tool for years 2000 to 2019. We compared the change in reimbursement rate for each procedure to the rate of inflation in US dollars, using the Consumer Price Index (CPI) over the same time period., Results: The reimbursement rate for each procedure increased on average by 13.9% during the study period while the United States CPI increased significantly more by 46.7% ( P < .0001). When all reimbursement data were adjusted for inflation to 2019 dollars, the average reimbursement for all included procedures in this study decreased by 22.6% from 2000 to 2019. The average adjusted reimbursement rate for all procedures decreased by 21.92% from 2000 to 2009 and decreased by 0.86% on average from 2009 to 2019 ( P < .0001)., Conclusion: When adjusted for inflation, Medicare reimbursement for hand surgery has steadily decreased over the past 20 years. It will be important to consider the implications of these trends when evaluating healthcare policies and the impact this has on access to hand surgery.

Gender disparities persist among medical subspecialty societies, including the American Society for Surgery of the Hand (ASSH). Surgical subspecialties in particular have lagged behind other medical specialties with respect to the number of women in training and practice. Orthopedic surgery, one of the surgical subspecialties making up hand surgery, has the lowest percentage of female residents and faculty among medical subspecialties. Institutions such as the ASSH have an important role in narrowing these gaps by creating environments that welcome female engagement by recognizing and promoting female surgeons into leadership positions. By summarizing demographic data, prior literature, and drawing from examples in other specialties, this article has 3 aims: (1) to review trends in female engagement in the ASSH; (2) outline the strategies that have been implemented to improve gender diversity within the ASSH; and (3) recommend feasible methods to address historical and ongoing barriers to promotion of women within the ASSH., (Copyright © 2022. Published by Elsevier Inc.)

The case being presented is a 35-year-old female with a 3-year history of progressive dyspnea and right-sided heart failure following spine surgery. Physical examination identified a continuous bruit in the lower abdomen radiating to her back which prompted further evaluation. Echocardiography showed normal left ventricle systolic function, enlarged right ventricle, functional tricuspid regurgitation, and moderate pulmonary hypertension. A computed tomography (CT) scan of the abdomen and pelvis demonstrated findings consistent with an arteriovenous fistula (AVF) between the right common iliac artery and the inferior vena cava. She underwent an uneventful endovascular repair without perioperative complication. The patient's symptoms resolved a few hours after the procedure and she continued to be symptom free at 3-month follow-up. This case illustrates an iatrogenic iliocaval fistula causing high-output cardiac failure which was successfully treated endovascularly with excellent clinical result., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Objective: Autogenous saphenous vein is the ideal conduit for lower extremity revascularization. Unfortunately, autogenous vein is unavailable in up to 20% of patients. Synthetic grafts provide an alternative; however, their use in distal revascularization has shown varying results. In addition, infected surgical sites preclude their use. Currently, there are limited outcome data for cryopreserved saphenous vein use in regard to long-term patency and limb salvage rates., Methods: Cryopreserved saphenous vein allograft use in infrainguinal bypass was studied retrospectively in a community setting. End points included primary patency, limb salvage, and early complications. Records of patients receiving cryopreserved allografts by nine vascular surgeons within one hospital system from 2006 to 2012 were reviewed., Results: Fifty-three patients, mean age 69 years (standard deviation, 12.3; range, 28-90 years), underwent 60 operations. Indications for surgery included limb-threatening ischemia (48%), tissue loss (30%), previous graft or site infection (10%), claudication (7%), or other (5%). The mean follow-up period was 23.9 months (standard deviation, 21.0; range, 0-64 months). Primary patency was maintained in 53% of patients at 1 year and in 22% at 3 years. Limb salvage was achieved in 74% of patients at 1 year and in 70% at 2 years. Thirteen early complications included 8 thromboses, 2 deaths, 2 amputations, and 1 anastomotic disruption. Fifteen patients (28%) underwent additional ipsilateral operations with use of synthetic conduits after initial cryopreserved allografts failed., Conclusions: Cryopreserved vein allografts displayed poor short-term and long-term patency, whereas limb salvage rates at 1 and 2 years remained acceptable. However, >25% of patients required additional ipsilateral operations with use of synthetic conduits after previous failed cryopreserved allograft use. Our data indicate that cryopreserved vein graft is a suboptimal choice of conduit in a noninfected field., (Copyright © 2014 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)

When primate infants are reared during the first half-year of life in an environment in which their mothers face uncertain requirements for food procurement (variable foraging demand [VFD]), long-lasting behavioral and neurodevelopmental consequences ensue, including increases in timidity and social subordinance as well as alterations in stress-related neuroendocrine profiles. We examined the nature and persistence of the effects of VFD rearing by exposing VFD-reared and normally reared adolescent bonnet macaques to a mild fear-provoking stimulus 2 years after the end of differential rearing. VFD-reared subjects at baseline were less gregarious than normally reared monkeys. VFDs also were considerably less responsive to the fear stimulus, and their behavior and affect returned to baseline levels more quickly than normally reared subjects. The extent and persistence of the sequelae of VFD rearing suggest parallels with predisposing factors in human anxiety disorders., (Copyright 2001 John Wiley & Sons, Inc.)

The main objective of this study was to examine the effects of human-computer interface design on postural dynamics, i.e., changes in working postures and postural discomfort exhibited by operators of the computer-based remote bar coding (RBC) system. In addition, the effects of different work/rest schedules on postural dynamics were evaluated. Twelve subjects participated in the laboratory experiment, which consisted of twelve scenarios utilizing two cognitive task requirement factors, i.e., (1) information presentation mode, defined through the letter image preview on the computer screen (none or one preview image); and (2) the information processing mode, defined through the specific keying method (key all characters or key 5 digits only). The third experimental factor was the work/rest schedule (50 min work/10 min break, 2 h of work/15 min break, or flexible schedule). The results showed that requirements of human-computer interface design significantly affected the operators' postural dynamics. It was concluded that not only the physical, organizational, or psychosocial work environment characteristics, but also the cognitive task characteristics are important for assessment of postural effects in the VDT work. The relationship between interface design, mental workload and postural dynamics should be carefully considered in future studies aimed at optimizing the human-computer data entry tasks.