Beaumont Health

About: Beaumont Health is a nonprofit organization based out in Royal Oak, Michigan, United States. It is known for research contribution in the topics: Medicine & Population. The organization has 1483 authors who have published 1448 publications receiving 15407 citations. The organization is also known as: William Beaumont Health System & Beaumont Hospitals.

Neuromodulation Treatment of Underactive Bladder

Abstract: While most clinicians know there is a lack of effective pharmacological treatment of the underactive bladder (UAB), not many physicians and nurses realize that there is a regulatory approved minimally invasive therapy for UAB. This technique is neuromodulation via sacral nerve stimulation (SNS).

Opportunistic Screening for Exposure to Bullying in the Pediatric Emergency Department.

Abstract: To assess opportunistic screening for exposure to bullying in the pediatric emergency department (ED), an anonymous survey inquiring about exposure to physical, verbal, social, and cyber bullying behaviors was given to ED patients 5 to 18 years old. The survey asked about being the recipient, perpetrator, and/or witness of bullying; the frequency of exposure; liking school; missing school; and presenting complaint. Either the child or parent could complete the survey. A total of 909 surveys were analyzed. Exposure was 78.7%. A greater proportion of females reported being victims and witnesses. Youth who reported being both victims and witnesses represented the largest group, with witness-only the second largest. Parents reported less cyber-bullying and witness status to all types of bullying. For children who did not like school, there was a significant difference in exposure versus nonexposure. There was no association with presenting complaint. Opportunistic screening for bullying exposure in pediatric ED patients warrants consideration as it may increase detection of preclinical status and clinical sequelae.

A Retrospective Study Analyzing the Appropriateness of Initial Treatment of Clostridium difficile in Patients with Active Malignancy.

Abstract: Background. Clostridium difficile infection (CDI) is the leading cause of hospital-associated gastrointestinal illness. Previous studies reported that patients with active malignancy are at high risk for CDIs, and yet they are still classified as nonsevere CDI and initially treated with metronidazole. Our aim is to investigate the need for the escalation of antibiotic therapy in patients with CDI and active cancer treated with oral metronidazole versus oral vancomycin. Methods. This is a retrospective study of adult patients admitted with CDI and any underlying active malignancy at Beaumont Hospital, Royal Oak, Michigan, from January 2008 to December 2014. Inclusion criteria included age > 18 years old, polymerase chain reaction- (PCR-) proven CDI, and active malignancy. Results. 197 patients were included in the final analysis. 44.8% of the metronidazole group required escalation of therapy compared to 15.2% in the vancomycin group ( value = 0.001). 29.8% of the combination group (metronidazole and vancomycin) underwent deescalation of antibiotics, which was significantly higher compared to 2.2% of patients in the vancomycin group ( value < 0.001). Discussion. Our results support the initial use of vancomycin or a combination (metronidazole and vancomycin) versus metronidazole in patients with CDI and active malignancy.

Traumatic Joint Injury Induces Acute Catabolic Bone Turnover Concurrent with Articular Cartilage Damage in a Rat Model of Post-Traumatic Osteoarthritis

Abstract: Objective: Assess acute alterations in bone turnover, microstructure, and histomorphometry following noninvasive anterior cruciate ligament rupture (ACLR). Methods: Twelve female Lewis rats were randomized to receive noninvasive ACLR or Sham loading (n=6/group). In vivo microCT was performed at 3, 7, 10, and 14 days post-injury to quantify compartment-dependent subchondral (SCB) and epiphyseal trabecular bone remodeling. Near-infrared (NIR) molecular imaging was used to measure in vivo bone anabolism (800 CW BoneTag) and catabolism (Cat K 680 FAST). Metaphyseal bone remodeling and articular cartilage morphology was quantified using ex vivo microCT and contrast-enhanced microCT, respectively. Calcein-based dynamic histomorphometry was used to quantify bone formation. OARSI scoring was used to assess joint degeneration, and osteoclast number was quantified on TRAP stained-sections. Results: ACLR induced acute catabolic bone remodeling in subchondral, epiphyseal, and metaphyseal compartments. Thinning of medial femoral condyle (MFC) SCB was observed as early as 7 days post-injury, while lateral femoral condyles (LFC) exhibited SCB gains. Trabecular thinning was observed in MFC epiphyseal bone, with minimal changes to LFC. NIR imaging demonstrated immediate and sustained reduction of bone anabolism (~15-20%), and a ~32% increase in bone catabolism at 14 days, compared to contralateral limbs. These findings were corroborated by reduced bone formation rate and increased osteoclast numbers, observed histologically. ACLR-injured femora had significantly elevated OARSI score, cartilage thickness, and cartilage surface deviation. Conclusion: ACL rupture induces immediate and sustained reduction of bone anabolism and overactivation of bone catabolism, with mild-to-moderate articular cartilage damage at 14 days post-injury.

Total Knee Replacement Techniques

Abstract: Total knee arthroplasty (TKA) is a viable treatment for symptomatic osteoarthritis of the knee refractory to conservative measures. In those with end-stage degenerative changes compromising the articular cartilage affecting multiple compartments of the knee, the literature has yet to identify a potentially viable alternative option for the regeneration of cartilage. Thus, TKA has demonstrated reproducible, long-term, successful results in such patients concerning outcomes of decreased pain and improved overall quality of life.Recent estimates project that by the year 2030, there will be 3.48 million TKAs performed annually. Although it is an extremely common and increasingly routine surgery, attention to detail is critical during the procedure to ensure that a well-balanced and functional TKA is performed to mitigate the risks of implanting components that might otherwise be subject to increased wear and early failure. Even with appropriate techniques, new technologic advances, and a better understanding of knee kinematics, approximately 1 out of 5 people that undergo a TKA will remain unsatisfied. There are numerous TKA designs and different levels of constraint that may be necessary for particular cases. Unicompartmental arthroplasty, cruciate retaining, and posterior stabilizing implants are typically used as potential index procedure options. However, in patients with significant varus/valgus instability, those undergoing revision surgery including component revisions, patients with preexisting poor bone quality, or in the setting of appreciable osseous defects, more constrained prosthetic components are given consideration. These include but are not limited to semi-constrained, hinged, or distal femoral replacement options.