Saint Francis University

About: Saint Francis University is a education organization based out in Loretto, Pennsylvania, United States. It is known for research contribution in the topics: Population & Osteoblast. The organization has 1694 authors who have published 2038 publications receiving 87149 citations.

Complex sternal and rib reconstruction with allogeneic material.

Abstract: Sternal malunion, or loss, developed after a median sternotomy cannot only be difficult to manage and treat, but also may diminish one’s quality-of-life drastically. The technique presented here represents a multispecialty approach in one stage for the reconstruction of an unstable thoracic cage. The procedure utilized a donated sternum and ribs. The sternum with ribs harvested from a single donor included adipose derived stromal vascular fraction (ADSVF) cells with marrow also from the same donor. Autologous muscle flaps, stabilized with acellular dermal matrix were utilized to provide a robust blood supply to the ADSVF cells and bone grafts. Acellular dermal matrix was used to construct the ribs and stabilize the plugs of stem cells and bone. These procedures, in the hands of multispecialty physicians, have led to several successful reconstructions involving complex chest wall deformities. This surgical intervention was performed in a one stage operation. This represents the first successful complete sternal transplant in a patient with return to normal activities and increased quality-of-life.

Front-loaded diazepam versus lorazepam for treatment of alcohol withdrawal agitated delirium.

Abstract: Background Front-loaded diazepam is used to rapidly control agitation in patients with severe alcohol withdrawal syndrome (AWS). Our institution began using front-loaded lorazepam in August 2017 secondary to a nation-wide shortage of intravenous (IV) diazepam. Currently, there are no studies comparing lorazepam to diazepam for frontloading in severe AWS. Method Retrospective cohort study of all adults presenting to the emergency department with a diagnosis of AWS and prescribed the institution's alcohol withdrawal agitated delirium protocol 8 months pre and post shortage of IV diazepam were eligible inclusion for the study. Of these, 106 patients were front-loaded with diazepam and 70 patients were front-loaded with lorazepam. Results There was no difference in the mean change in Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised scores 24 h pre and post front-loading in the two groups (−13.9 ± −8.08 vs. −13.1 ± −8.91, p = 0.534). Patients who received front-loaded lorazepam had an increased incidence of ICU-delirium (positive for the Confusion Assessment Method in the ICU: 75% with lorazepam vs. 52.6% with diazepam, p = 0.009) and a higher risk of over-sedation, but this did not reach statistical significance (Richmond Agitation-Sedation Scale score Conclusion Front-loaded lorazepam was similar to front-loaded diazepam in controlling AWS symptoms. Lorazepam's delayed onset of action should be considered when determining how quickly repeat doses are administered to avoid the potential for adverse drug events.

Paget-Schroetter Syndrome: a case report of diagnosis, treatment, and outcome in a healthy 18-year-old athletic swimmer

Abstract: Paget-Schroetter Syndrome is a rare condition in the spectrum of deep vein thromboses involving spontaneous upper extremity venous thrombosis in the axillary-subclavian vein. The syndrome usually occurs in young, healthy individuals and is a progressive, anatomic manifestation of venous thoracic outlet syndrome. Thrombosis is secondary to repetitive overuse of the arm, leading to compression, microtrauma, and local inflammation of the particularly vulnerable subclavian vein in the thoracic outlet at the junction of the first rib and clavicle. The condition is often misdiagnosed because of its rarity and can lead to significant disability and morbidity if treatment is delayed. In this case report, Paget-Schroetter Syndrome, causing significant pain and dysfunction, is presented in an 18 year-old female freestyle-swimmer that was successfully treated with anticoagulation, thrombolysis, thoracic outlet decompression and first rib resection, scalenectomy, venolysis, and venoplasty. Early suspicion of this condition can lead to prompt diagnosis, and subsequent aggressive interventional treatment with catheter-directed thrombolysis and thoracic outlet decompression, in addition to anticoagulation, demonstrated success in achieving complete resolution of symptoms in this case.

Changing the Face of Hockey: A Study of the Half-Visor's Ability to Reduce the Severity of Facial Injuries of the Upper-Half of the Face among East Coast Hockey League Players

Abstract: Objective: The purpose of the study was to identify the effectiveness of half-visors by qualitatively comparing the severity, location, and mechanism of facial injuries involving the upper-half of the face among an equal number of East Coast Hockey League (ECHL) players with and without half-visors. Full visors were not included in the study because ECHL players do not wear full visors. Design: A stratified sample was retrospectively collected from 5 seasons of ECHL players who suffered facial injuries to the upper-half of the face with and without half-visors. The upper-half of the face is the region purported to be protected by the half-visor. A total of 186 injuries were identified to the upper-half of the face (93 wore half-visors and 93 wore no protection). Setting: Johnstown Cambria County War Memorial Arena, Johnstown, PA. Results: High-sticking was the most common mechanism of injury. Injury severity scores for lacerations with standard deviations by injury location (ie, forehead, cheek) were statistically significant in the half-visor group when compared with the no-visor group. The injury severity scores for contusions due to collisions were statistically higher in the no-visor group compared with the half-visor group. Conclusions: Most injury mechanisms occur from an upward trajectory, which could easily slip under the half-visor and strike the upper-half of the face and eye region. The half-visor may not adequately protect the upper-half of the face from common injury mechanisms. Language: en