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.

COVID-19 and the healthcare workers.

Abstract: It was a war unlike any other. Family members picked sides; treasured cousins, childhood playmates, beloved uncles and grandfathers, and revered teachers faced off on the battlefield, preparing to slaughter each other. It was, after all, a war that would decide ‘dharma’—the inherent order of reality that is nurtured by right thought and action. The famous archer Arjuna, the hero of this story, was caught in a moral dilemma. He was sure that he was on the side of dharma but could not imagine fighting his loved ones. ‘I quit’, he said. Fortunately for him, his charioteer was Krishna, an embodiment of dharma. In what would come to be known as the Bhagavad Gita (the ‘Lord’s Song’), Krishna taught Arjuna the ways of skilful living. In the 5000 years since the description of the war of Kurukshetra, the Bhagavad Gita has proven to be an accurate guide for living a fulfilling life—a life aligned with dharma. Krishna’s advice to Arjuna was simple. Being a warrior committed to protecting his people, Arjuna’s only dharma was to fight, and not worry who he was fighting or the outcome of the war. To be able to do what is needed without becoming attached to the result is the way of living a

Surgical treatment of femoroacetabular impingement: Hip arthroscopy versus surgical hip dislocation: A propensity-matched analysis

Abstract: Background Surgical treatment of femoroacetabular impingement (FAI) continues to evolve and is most commonly approached with either hip arthroscopy (HA) or surgical dislocation (SD) of the hip. The purpose of this study was to compare the outcomes of similar patients undergoing surgical treatment of FAI with either HA or SD. Methods A prospective multicenter cohort study of patients undergoing primary surgical treatment of FAI was performed. Follow-up at a minimum of 1 year (mean, 4.3 years) was available for 621 hips (81.7%), including 399 procedures with HA and 222 procedures with SD. Propensity scores were calculated and reflect the likelihood of surgical treatment with HA versus SD for a given set of covariates. Propensity scores allowed 1:1 matching to identify similar patients at baseline. After propensity matching, 128 matched pairs of patients who underwent HA and 128 matched pairs of those who underwent SD were included in the study. The primary outcome was the postoperative modified Harris hip score (mHHS); secondary outcomes included the Hip disability and Osteoarthritis Outcome Score (HOOS), the University of California Los Angeles (UCLA) activity score, and the Short Form-12 (SF-12) physical and mental subscores, as well as the rate of persistent symptoms, revision surgery, and total hip arthroplasty (THA). Results After propensity matching, the 2 groups exhibited similar distributions of all of the covariates that were included in the model. Both groups demonstrated significant improvements in all patient-reported outcomes (PROs). The final mHHS was not significantly different between the 2 matched groups (81.3 for the HA group versus 80.2 for the SD group, p = 0.67). Likewise, the HOOS pain subscale was similar at the time of final follow-up (77.6 versus 80.5, respectively, p = 0.32). No difference between the HA group and the SD group was identified in the rate of THA (0% and 3.1%, respectively, p = 0.41) and revision surgery (7.8% and 10.9%, respectively, p = 0.35); overall rates of persistent symptoms were 21.9% for the HA group and 24.4% for the SD group (p = 0.55). Conclusions In a propensity-matched analysis of patients who were treated with either approach, patients undergoing HA or SD demonstrated similar outcomes at a mean of 4 years postoperatively. Level of evidence Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Psoas Compartment Block vs Periarticular Local Anesthetic Infiltration for Pain Management After Anterior Total Hip Arthroplasty: A Prospective, Randomized Study.

Abstract: Background The psoas compartment block (PCB) or periarticular soft-tissue local anesthetic injection are forms of regional anesthesia often used as one of the components in multimodal anesthesia applied during total hip arthroplasty (THA). The most efficacious form of regional anesthesia for THA has yet to be determined. Methods In a single-surgeon, prospective, clinical trial, patients undergoing THA via direct anterior approach were randomized to receive an intraoperative periarticular local anesthetic infiltration (periarticular injection) or a PCB. Postoperative pain scores, narcotic consumption, and complications were recorded. Results Forty-nine patients were randomized to the PCB and 50 were randomized to the periarticular injection. The resting pain score 3 hours postoperatively was statistically significantly lower in the periarticular injection group by 1.1 point (2.9 ± 2.2 vs 4.0 ± 2.2, P = .036). No difference was found in resting pain scores or ambulatory pain scores in the morning or evening of postoperative day 1, 2, or at the 3-week follow-up visit. There was no difference in in-hospital narcotic consumption between groups (P = 1.0). There were no major complications directly related to the block in either group. A total of 6 patients reported complaints of transient numbness, 5 in the PCB group (5/49, 10.2%), and one in the periarticular injection group (1/50, 2%, P = .087). Conclusion These results demonstrate similarity between the 2 methods. We prefer periarticular anesthetic infiltration over PCB due to improved immediate postoperative pain scores and avoidance of potential symptoms associated with nerve blockade.

Inhibition of Colony-Stimulating Factor-1 Receptor Enhances the Efficacy of Radiotherapy and Reduces Immune Suppression in Glioblastoma.

Abstract: Aim To use inhibition of colony-stimulating factor-1 receptor (CSF-1R) to target tumor-associated macrophages (TAMs) and improve the efficacy of radiotherapy in glioblastoma (GBM). Materials and methods The CSF-1R inhibitor BLZ-945 was used to examine the impact of CSF-1R inhibition on M2 polarization in vitro. Using an orthotopic, immunocompetent GBM model, mice were treated with vehicle, RT, BLZ-945, or RT plus BLZ-945. Results BLZ-945 reduced M2 polarization in vitro. BLZ-945 alone did not improve median overall survival (mOS=29 days) compared to control mice (mOS=27 days). RT improved survival (mOS=45 days; p=0.02), while RT plus BLZ-945 led to the longest survival (mOS=not reached; p=0.005). Resected tumors had a relatively large population of M2 TAMs in GBM at baseline, which was increased in response to RT. BLZ-945 reduced RT-induced M2 infiltration. Conclusion Inhibition of CSF-1R improved response to RT in the treatment of GBM and may represent a promising strategy to improve RT-induced antitumor immune responses.