Objective: Given the rise of martial arts within the fitness and recreational industry, it is important to study trends in injury and note that practicing martial arts comes with a risk of injury, particularly to the upper extremities. By studying consumer product-related injuries to the upper extremities and addressing the current gap in the literature, future martial arts equipment can come with increased safety features, better provide information to healthcare providers treating such injuries, and improve risk mitigation through the Consumer Product Safety Commission. Methods: The National Electronic Injury Surveillance System Database was analyzed to collect data on martial arts equipment-related injuries on the upper extremities within the last 10 years. Results: Over the most recent span of 10 years (2013-2022), there were approximately 78,680 injuries reported to the ED. The majority of them took place in 2013 (12.8%). Men were 2.4 times more likely to get injured than women. Injuries peaked in the age group 10-19-year-olds (33%) and particularly age 12 (4.8%). The upper extremity most commonly affected was the shoulder (29.1%), and the most common diagnosis group was a fracture (29.2%). Most injuries presented to the emergency department were not hospitalized (98.7%). Conclusions: This study highlights the occurrence of upper extremity injuries due to martial arts within the last 10 years and provides new information on the prevalence of such injuries. The results highlight that these injuries are usually non-severe and most commonly affect adolescent males; however, future research should explore performance-based recovery post-injury and long-term pain.
INTRODUCTION: The emergence of artificial intelligence (AI) chat programs has opened two distinct paths, one enhancing interaction and another potentially replacing personal understanding. Ethical and legal concerns arise due to the rapid development of these programs. This paper investigates academic discussions on AI in medicine, analyzing the context, frequency, and reasons behind these conversations. METHODS: The study collected data from the Web of Science database on articles containing the keyword "ChatGPT" published from January to September 2023, resulting in 786 medically related journal articles. The inclusion criteria were peer-reviewed articles in English related to medicine. RESULTS: The United States led in publications (38.1%), followed by India (15.5%) and China (7.0%). Keywords such as "patient" (16.7%), "research" (12%), and "performance" (10.6%) were prevalent. The Cureus Journal of Medical Science (11.8%) had the most publications, followed by the Annals of Biomedical Engineering (8.3%). August 2023 had the highest number of publications (29.3%), with significant growth between February to March and April to May. Medical General Internal (21.0%) was the most common category, followed by Surgery (15.4%) and Radiology (7.9%). DISCUSSION: The prominence of India in ChatGPT research, despite lower research funding, indicates the platform's popularity and highlights the importance of monitoring its use for potential medical misinformation. China's interest in ChatGPT research suggests a focus on Natural Language Processing (NLP) AI applications, despite public bans on the platform. Cureus' success in publishing ChatGPT articles can be attributed to its open-access, rapid publication model. The study identifies research trends in plastic surgery, radiology, and obstetric gynecology, emphasizing the need for ethical considerations and reliability assessments in the application of ChatGPT in medical practice. CONCLUSION: ChatGPT's presence in medical literature is growing rapidly across various specialties, but concerns related to safety, privacy, and accuracy persist. More research is needed to assess its suitability for patient care and implications for non-medical use. Skepticism and thorough review of research are essential, as current studies may face retraction as more information emerges.
Mastoiditis is typically considered a suppurative complication of otitis media seen in children. Vaccines and therapeutics can change the demographics of diseases. Childhood vaccination against Haemophilus influenza, for example, has shifted the mean age for ear, nose, and throat infections caused by this bug to age 25, whereas this used to be most prevalent in the pediatric age group previously. The authors present the case of an 82-year-old man who had mastoiditis. This case serves as a reminder to avoid anchoring bias when seeing an undifferentiated patient in the emergency department.
Cancer is a debilitating disease for which patients often need caretakers to help them live their lives and complete basic activities. This study aims to characterize the burden of the caretaker. A 14-question survey was sent out to randomly selected United States cancer caretakers to analyze the social, emotional, and physical burden of their caretaking. The results show that a majority of caretakers are direct family to the patient (69.5%). The patients' cancers are often in early stages with about 54.5% having stage 1 cancer and 22.5% having stage 2 cancer while only 8.5% had stage 3 cancer and 17.8% had stage 4 cancer. When asked about their motivation, caretakers most often do it because of love (58.82%) with family responsibilities/duty being the second highest reason (35.56%). When asked about their biggest burden, many caretakers said that grief was the biggest issue (30.50%) with mental health issues also being troublesome (28%). 75.6% of respondents said that being a cancer caretaker has negatively impacted their mental health from either anxiety (37.29%), depression (33.9%), or other conditions (4.41%). When asked about the negative impacts of being a caregiver, 43.5% stated they faced high financial costs to give care, and 35% stated they met a lack of social support or lost friends. In comparison, 33% stated they had negative physical impacts. The number of participants who face overwhelming or high stress nearly quintupled from baseline, from 13% to 59.5%. This cross-sectional survey of US adults demonstrates that there are clear negative impacts on cancer caregivers on their physical, financial, social, and mental health. These data underscore the importance of taking care of patients' caregivers.
Objective: This study aims to identify motivators influencing individuals' commitment to maintaining positive health trajectories across different demographics. The primary objective is to leverage this knowledge to enhance patient-physician relationships and improve the quality of care. Methods: A web-based survey collected data from 204 randomly selected participants aged 16 and older. The survey assessed participants' self-rated health, health-related habits, and motivators for a healthy lifestyle. Open-ended responses were included. Results: Participants had a mean self-rated health score of 6.24 (scale: one to ten). Motivation scores for health-related factors averaged 3.25 (scale: one to five), with caregiving responsibility scoring 3.07 (scale: one to five), mainly among women. Motivators related to personal productivity and values scored 3.44 (scale: one to five), while cultural or religious beliefs scored lowest at 2.89 (scale: one to five). Common themes from free responses included longevity, quality of life, personal well-being, family, independence, prevention of complications, health goals, finances, and faith, listed by frequency. Among participants, only 30% had chronic diseases, but 80% of those with chronic conditions were motivated to improve their health. Conclusion: This survey gathered valuable data on motivators for maintaining positive health trajectories. The findings have implications for improving patient-physician relationships and healthcare delivery. Understanding individuals' motivators can inform tailored interventions and personalized care approaches.
Background: Replacement arthroplasty surgery is a surgical procedure that is needed to restore the activity of a joint. Patient satisfaction regarding arthroplasty surgery is influenced by post-operative complication rate, ability to afford care, and quality of interaction. In this study, we assessed patients' postoperative complications, mobility, and pain management as proxies for their overall satisfaction with total joint replacement (TJR). Methods: An anonymous web-based survey was conducted for patients who had undergone any total joint replacement surgery in the US. Respondents were adults living in the United States. Results: 180 individuals met the inclusion criteria and responded to the survey. Age, education, gender, and race were fitted against the patient satisfaction level with the surgeon. While education [P=0.4720], gender [P=0.5097 ], and race [P=0.8183] were not significant, age in years [P=0.02340] was predictive of overall satisfaction levels [R2=0.0213]. When controlling for BMI, infection [P=0.0164], nerve damage [P=0.0250], delayed healing [P=0.0024], hematoma [P=0.0497], were more likely to occur in participants who have had a knee replacement, as compared to shoulder and hip replacement surgery. When controlling for mobility before surgery vs. mobility after surgery [P=0.0114], patients who selected the highest level of mobility before surgery were likely to select the highest level of mobility after surgery. Medicaid, Medicare, private insurance, employer-based insurance, and no insurance were fitted against the patient's self-reported difficulty in paying for their treatment/care. Although employer-based insurance [P=0.0790] was not significant in predicting difficulty in paying for the surgery, patients with Medicaid [P=0.0280], Medicare [P=0.0200], or private insurance [P=0.0343] did. Conclusion: In this cohort, older patients were associated with having improved satisfaction with the surgeon who performed their joint replacement. Complications were higher in patients who underwent a knee arthroplasty compared to a shoulder or hip arthroplasty.
INTRODUCTION: Recognizing and understanding risk factors for craniofacial injury in the elderly is of paramount importance in prevention. This research aims to investigate the prevalence of craniofacial injuries in connection with extrinsic preventable factors, particularly identifying common household products that pose the greatest risk for such injuries. MATERIALS AND METHODS: This study was done with the utilization of the 2013 to 2022 National Electronic Injury Surveillance System (NEISS). Data gathered included patient age, injury type, cause of injury, and year of incidence. "Elderly" was defined as an individual of 65 years of age or older. RESULTS: There was a total of 9,703,688 estimated national cases of elderly craniofacial injury from 2013 to 2022. In all, 5,888,112 (60.68%) of these occurred in females. In descending order, the 5 most common items responsible for craniofacial injury in the elderly are floors/flooring Materials (3,741,706, 30.92%), beds/bed frames (1,250,396, 10.33%), stairs/steps (907,92, 7.50%), chairs (546,697, 4.52%), and tables (453,989, 3.75%). These top 5 account for roughly 57% of all cases. The 5 most common presenting diagnoses were internal injury (2,957,095, 40.21%), lacerations (1,435,926, 19.53%), ABR (1,191,008, 16.20%), fracture (568,842, 7.74%), and hematoma (355,871, 4.84%). CONCLUSIONS: Out of the roughly 10 million cases of craniofacial injury in the last decade, ~three-fifths have happened to women. The majority of injuries occur in a home setting. The overwhelming majority of cases were related to the product code 1807-floors or flooring materials, and the largest diagnosis was internal injury by a wide margin. Evidently, there is a large population of elderly patients who suffer from craniofacial injuries related to objects and items that permeate within their living residences. The elimination of excess elderly craniofacial injury can be achieved by reducing fall risk factors in the immediate vicinity of the elderly.
This paper is a summary of the evolution of the tuning fork, a crucial part of the cranial nerves and auditory examination. The tuning fork is a two-pronged fork that resonates at a specific pitch when struck against a surface and has been proven to be incredibly useful in diagnosing and detecting hearing disorders. The tuning fork, an unassuming device in modern medicine, traces its origins back to an era when scientific understanding and medical diagnostics were in their nascent stages. Since its inception, this unpretentious instrument has played a pivotal role in the hands of healthcare practitioners, aiding in the diagnosis and assessment of various medical conditions. This paper embarks on a captivating journey through time to explore the origin, evolution, and significant milestones in the development of the tuning fork. From the first suggestion of differentiating hearing disorders to present-day tuning forks, this paper maps the different stages that the tuning fork has gone through and how its use has changed over time. Along the way, we will discover how the tuning fork has harmonized with music, medicine, and various scientific pursuits, enriching our understanding of sound and resonance while leaving an indelible mark on the course of human history. Delving into the historical context of its creation, this review uncovers the ingenious minds that birthed this innovative device and the pivotal moments that brought it to the forefront of human endeavors.
BACKGROUND/OBJECTIVE: Alzheimer's disease is a prominent neurodegenerative disorder characterized by cognitive decline and memory loss. Variations in subjective cognitive decline among Alzheimer's patients, often reported by caregiver, may stem from cultural, socioeconomic, healthcare access, and genetic factors. This study investigates racial disparities in subjective cognitive decline reported by caregivers and their implications. METHODS: In this study, data from 12,627 Alzheimer's caretakers from the CDC's Alzheimer's Disease and Healthy Aging Data Portal were analyzed using JMP software. Caregivers reported patients' cognitive decline for various racial categories: Asian/Pacific Islander, Black, Hispanic, Native American/Native Alaskan, and White. Fit model tests and distribution analyses were employed to assess disparities in symptom severity. The study focused on four key questions regarding symptom prevalence and healthcare communication to assess the degree of symptoms the patients were experiencing. RESULTS: Significant disparities in symptom severity reported by Alzheimer's caretakers were observed among the racial groups analyzed. The symptom severity ranked from least to most severe is the following: White, Asian/Pacific Islander, Black, Native American/Native Alaskan, and Hispanic patients. There was variance when it came to communication with healthcare providers, as the Asian population had the lowest communication rates. These findings underscore the need for targeted interventions considering cultural differences. It is important that tailoring healthcare approaches for different racial backgrounds is happening as a remedy to this gap in communication. CONCLUSION: Due to cultural, socioeconomic, genetic factors, and others, there were significant observed disparities. Tailoring interventions to these diverse populations is crucial to address these inequities.
Alzheimer Disease , Cognitive Dysfunction , Humans , United States/epidemiology , Healthcare Disparities , Racial Groups , Hispanic or Latino
PURPOSE OF REVIEW: While primary headaches like migraines or cluster headaches are prevalent and often debilitating, it's the secondary headaches-those resulting from underlying pathologies-that can be particularly ominous. This article delves into the sinister causes of headaches, underscoring the importance of a meticulous clinical approach, especially when presented with red flags. RECENT FINDINGS: Headaches, one of the most common complaints in clinical practice, span a spectrum from benign tension-type episodes to harbingers of life-threatening conditions. For the seasoned physician, differentiating between these extremes is paramount. Headache etiologies covered in this article will include subarachnoid hemorrhage (SAH), cervical artery dissection, cerebral venous thrombosis, meningitis, obstructive hydrocephalus, and brain tumor.
Brain Neoplasms , Cerebrovascular Disorders , Meningitis , Migraine Disorders , Humans , Headache/etiology , Headache/complications , Migraine Disorders/complications , Cerebrovascular Disorders/complications , Brain Neoplasms/complications , Meningitis/complications
BACKGROUND: For many conditions, a timely visit to the Emergency Department (ED) can have a tremendous impact on the patient's outcome. However, the decision to visit the ED in a time of need can be stressful. Our study aims to understand whether cost was a factor for seeking ED care, and if any particular subgroups including race, ethnicity and sex were less likely to obtain such care. METHODS: A web-based survey of US adults was conducted to assess participants' ED access, estimates of the cost of visiting, and their overall levels of comfort in seeking emergency care. Statistical analyses performed in JMP 16.1 for the Mac. RESULTS: Multivariate regression modeling demonstrated that women (pâ¯=â¯0.0241), participants employed for wages (pâ¯=â¯0.0257), or self-employed (pâ¯=â¯0.0019) are less likely to visit the ED due to cost. Conversely, retired individuals are significantly less likely to encounter cost as a restriction (pâ¯=â¯0.0081). CONCLUSION: In a national survey sample that asked about whether cost was a factor in visiting the emergency department, women and people who worked for wages or were self-employed were most likely to think twice about cost.
Emergency Room Visits , Emergency Service, Hospital , Adult , Humans , Female , United States , Employment , Costs and Cost Analysis
Intracerebral hemorrhage is the most serious type of stroke, leading to high rates of severe disability and mortality. Hematoma expansion is an independent predictor of poor functional outcome and is a compelling target for intervention. For decades, randomized trials aimed at decreasing hematoma expansion through single interventions have failed to meet their primary outcomes of statistically significant improvement in neurological outcomes. A wide range of evidence suggests that ultra-early bundled care, with multiple simultaneous interventions in the acute phase, offers the best hope of limiting hematoma expansion and improving functional recovery. Patients with intracerebral hemorrhage who fail to receive early aggressive care have worse outcomes, suggesting that an important treatment opportunity exists. This consensus statement puts forth a call to action to establish a protocol for Code ICH, similar to current strategies used for the management of acute ischemic stroke, through which early intervention, bundled care, and time-based metrics have substantially improved neurological outcomes. Based on current evidence, we advocate for the widespread adoption of an early bundle of care for patients with intracerebral hemorrhage focused on time-based metrics for blood pressure control and emergency reversal of anticoagulation, with the goal of optimizing the benefit of these already widely used interventions. We hope Code ICH will endure as a structural platform for continued innovation, standardization of best practices, and ongoing quality improvement for years to come.
Ischemic Stroke , Stroke , Humans , Stroke/therapy , Cerebral Hemorrhage , Blood Pressure/physiology , Hematoma
The authors present the case of a 39-year-old male who presented to the hospital with worsening eye pain, swelling, and blurred vision of the left eye. His symptoms grew worse despite initial over-the-counter medication and a trip to the urgent care center. A physical exam was concerning for a possible orbital cellulitis given the appearance of the eye and the amount of discomfort, as well as their immunocompromised status, necessitating imaging and workup to confirm the diagnosis. The patient was ultimately diagnosed with periorbital cellulitis and bacterial conjunctivitis, and he received intravenous antibiotics for treatment. This case underscores the importance of a comprehensive diagnostic approach to managing ocular infections.
Introduction: Access to healthcare is defined by being able to receive regular checkups, specialist appointments, immunizations, procedures, and surgeries within a reasonable timeframe and without restrictive barriers. Methods: The Web of Science database was used to collect 4,745 articles published relating to the keywords "rural", "access", and "healthcare". These articles then underwent bibliometric cataloging by country, journal, and keyword using VOSviewer 1.6.19. Results: Between the years 2015 and 2022, the United States emerged as the predominant publisher in the field. From 2015 to 2019, the United States accounted for 47 percent of the total articles published. However, in the subsequent years of 2020 to 2022, there was a slight decline of 3 percent in the volume of U.S. publications. Australia secured the second position in terms of publications within the aforementioned timeframe of 2015 to 2022. England had the third most publications during the time between 2015 to 2022. The prevalence of articles containing the keyword "disparity" ranged between 7 percent and 12 percent throughout this period. Plus One exhibited prominence by contributing 5.025381 percent of all publications pertaining to access to rural medicine during the years 2015 to 2019 thereby establishing itself as the leading publisher in this domain. However, in 2020, the International Journal of Environment suppressed Plus One by publishing the highest number of articles related to rural healthcare. Subsequently, the BMC Health Services Research claimed the leading position in the years 2021 to 2022. Conclusion: An exploration of who is contributing to the discussion of access to healthcare in rural communities shows that the field and number of publications is growing, and that a focus on disparities is emerging, creating an environment surrounding rural health focused on researching equitable care.
Objective: Doctor-patient communication is an essential clinical practice necessary to improve overall patient experience and their adherence to treatment. This form of communication involves first, listening without interruptions and then, conveying information in a clear and concise manner. Methods: A bibliometric analysis was conducted on publications extracted from the Web of Science database related to doctor-patient communication from 2012 to 2022 using the VOSviewer 1.6.15 software to visualize trends. Results: 20,376 articles were from 2012 to 2022 met the inclusion criteria of being recognized by the search phrase "physician-patient communication." Throughout the defined time period, USA, Canada, and Germany consistently took the top three positions in terms of publishing the most articles regarding the topic. Additionally, the Patient Education and Counseling Journal was the journal with the most publications regarding the topic. Innovation: A bibliometric analysis is a relatively novel way to frame research in a given area. It allows researchers to analyze trends in publication, and capture data from multiple disciplines. Conclusion: The number of articles published annually regarding doctor-patient communication has constantly been increasing from 2012-2022, demonstrating its importance as a crucial component of effective health care.
The authors present the case of a 64-year-old male who presented to the emergency department due to foot trauma. He sustained a large subungual hematoma, which was drained. Following the procedure, the patient achieved complete resolution of his pain. He also reported no complications at two-week phone follow-up. The management of subungual hematoma, including the trephination procedure, is discussed. Potential complications, although rare, are reviewed.
We report on the case of a 52-year-old male who sustained a transverse patellar fracture after tripping on uneven pavement. These fractures can be easy to miss on anteroposterior views, highlighting the importance of multiple radiographic views of the knee. Examination of the knee is also important, as initial clinical appearance can be benign. These fractures are most often seen in adolescents, which makes the current case somewhat unusual.
Objective: While generally considered a safe sport, archery injuries are often the result of overuse or penetration and largely affect the upper extremities. Studies have shown that during training periods the average risk of injury is 4.4%. By studying mechanisms of injury and their prevalence nationally, this study aims to educate coaches, athletes, and equipment manufacturers on ways the sport can be safer from a clinical perspective. Methods and Materials: The National Electronic Injury Surveillance System Database was queried to analyze archery-related musculoskeletal injuries that occurred between 2013 and 2022. Results: Approximately 43,083 injuries were recorded over a 10-year span, of which 8,038 were women and 35,367 were men. Men were thus 4.4 times more likely to experience injury during archery. Injury sites in men included the finger (66.2%), hand (17.1%), face (6.2%), shoulder (5.4%), and foot (5.1%). All reported injuries in women were finger-related. The most common diagnoses for men were lacerations (58.1%), fractures (12.7%), contusions and abrasions (7.5%), foreign body (5.9%), punctures (4.9%), and strains/sprains (4.9%). Women exclusively experienced lacerations, accounting for 100% of their injuries. Conclusion: The study identifies that lacerations were the most common archery-related injury that was treated in the ED. Additionally, the fingers were the most common site of injury. Findings from this study suggest that improved safety equipment, such as reinforced gloves, finger tabs, and forearm braces should be used by athletes to practice the sport more safely. Future research could involve studying injury rates in archers who use each combination of these safety precautions to investigate which gear is most protective.
OBJECTIVE: To determine if there is a racial disparity in satisfaction with maternal healthcare, and examine the quality of care mothers of color receive. METHODS: An online survey of women in the United States who had been pregnant at least once was conducted. The study received an exempt determination by our Institution's Review Board. RESULTS: Race, age, income, were all significant indicators for whether a woman was satisfied with maternal healthcare measures. CONCLUSION: Race is one of many indicators for dissatisfaction with maternal healthcare. More in-depth research on patient perception of care is recommended.
Black or African American , Hispanic or Latino , Pregnancy , Female , Humans , United States/epidemiology , Healthcare Disparities , Mothers , Personal Satisfaction
Syphilis is caused by the spirochete Treponema pallidum and classically progresses through a series of stages with increasing symptomatology if unrecognized and untreated. Importantly, central nervous system invasion can occur at any stage, which can lead to variable presentations of neurosyphilis. One such manifestation is meningovascular syphilis, which causes thrombosis of the cerebral vasculature, leading to stroke-like symptoms such as hemiplegia and aphasia. Young, healthy patients may present with these symptoms without any risk factors typically associated with the pathophysiology of cerebrovascular accidents. Further, patients living with HIV who present with stroke-like symptoms should have an even higher suspicion for neurosyphilis as a potential diagnosis. We present a case report of a 31-year-old male with sudden left-sided weakness and numbness who tested positive for both Treponema pallidum and human immunodeficiency virus (HIV).
