RESUMO
A significant public health burden exists related to firearm-related injuries in the United States. Primary care physicians (PCPs) find themselves on the frontline to address it. This study aimed to determine if PCPs feel prepared and responsible for providing firearm safety counseling. Data were gathered via a direct 23-question survey of family medicine, internal medicine, and pediatric physicians and residents in North and Central Texas between May 2019 and January 2020. The survey was delivered to 518 outpatient providers, with a 24% response rate. Associations were assessed by chi-square/Fisher's exact test. A total of 62% agreed that preventable firearm death is an important health issue and PCPs can have a positive effect; 10% felt their residency provided or provides opportunities to learn about firearm safety and how to counsel patients; 55% agreed that a standardized tool to question and counsel patients on firearm safety such as a template in the electronic health record would be useful; and 68% stated they would use a standardized template in their practice if proven to reduce firearm-related injuries. Physicians who had received training in residency felt their knowledge was adequate to be able to provide meaningful counseling to patients (P < 0.001). In conclusion, PCPs are pivotal in addressing firearm safety. A formal curriculum across primary care specialties' graduate education programs should be developed to improve physicians' competency in addressing firearm safety. Further investigation into standardized tools that could be implemented into an electronic health record may help bridge the gap from awareness to implementation of interventions.
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This study investigates the impact of Colles versus scaphoid casts on hand function in modern day activities using the Jebsen Hand Function Test with additional modified subtests including texting on a mobile phone, using a computer mouse and typing on a computer keyboard. Twenty healthy volunteers were recruited for the study. Study participants performed worse in a scaphoid cast compared to a Colles cast; most evident in tasks involving fine motor movements such as writing, picking up small objects and stacking checkers (mean time difference 2.3 seconds, 1.5 seconds and 1.2 seconds, respectively) and tasks involving forearm rotation such as card turning and picking up large light objects (mean time difference 1.6 seconds and 1.1 seconds, respectively). This study highlights the importance of careful consideration when assessing the need for thumb immobilization, due to its impact on hand function when performing both traditional and modern-day activities of daily living.
Assuntos
Moldes Cirúrgicos , Osso Escafoide , Atividades Cotidianas , Antebraço , Humanos , PolegarRESUMO
Objective: To determine the presentation, management, and outcome of cryptorchidism in Dalhatu Araf Specialist Hospital, Lafia, Nigeria. Materials and Methods: This is a retrospective study conducted at Dalhatu Araf Specialist Hospital, Lafia, Nigeria. Information of patients who presented with cryptorchidism to the hospital from January 2015 to January 2020 was retrieved from the folders and analysed. Results: A total of 37 patients were studied during the study period. Only three (8.1%) presented and had correction before/at the age of two. A majority of patients (91.9%) presented after the age of two; 78% of the testes were palpable. The condition was unilateral in 30 patients (81.1%) and bilateral in seven patients (18.9%). Laparoscopy was used in one (2.7%) patient. A majority (51.4%) of the testes were in the inguinal canal, 29.7% at the external ring, 13.5% at the internal ring, and 5.4% within the abdomen. Orchidopexy was performed for 41 undescended testes and orchidectomy for three atrophic testes. There was a good outcome in 93.2% of the surgical corrections. Scrotal haematoma developed following two orchidopexies and one (2.2%) testis retracted. Conclusion: Cryptorchidism is a common anomaly in urology. The correction of cryptorchidism at the appropriate age is indicated to optimise testicular function, potentially reduce and/or facilitate the diagnosis of testicular malignancy, provide cosmetic benefits, and prevent complications such as a clinical hernia or torsion. Education of parents, traditional birth attendants, midwives, and doctors in our environment is required to ensure earlier presentation and treatment.