Community organization factors affecting veteran participation in adaptive sports.

Objective: This study aims to describe United States military veteran participation in adaptive sports and to assess the demographic make-up and organizational characteristics of existing adaptive sports programs.Design: Prospective, cross-sectional survey.Setting: Community organizations with adaptive sports programs.Participants: 85 adaptive sports programs.Interventions: Nine question survey.Outcome Measures: Demographic data and sports offered by adaptive sports programs in the United States.Results: The survey response rate was 70%. The median number of total participants in an organization was 75 and the median number of veterans was 50. 76% of organizations had some degree of affiliation with a VAMC. Organizations affiliated with a VAMC are more likely to be rehabilitation centers, whereas community organizations with no VAMC affiliation are most commonly independent organizations with no rehabilitation component. Individuals of all ages participate in adaptive sports, with increasing participation associated with increasing age. Golf was the sport offered most commonly by adaptive sports programs in this survey. Low-contact sports were offered more often than high-contact sports, and the majority of programs offered adaptive sports year-round.Conclusions: Our results suggest that U.S. Military veterans represent a large proportion of the individuals participating in adaptive sports. Further research specifically focusing on factors veterans find desirable when considering participating in adaptive sports is indicated to identify programs that should be promoted, developed, and funded to increase veteran participation in adaptive sports.

Diagnosis of Culture-Negative Septic Arthritis with Polymerase Chain Reaction in an Immunosuppressed Patient: A Case Report.

CASE: We present a 23-year-old woman on immunosuppressive therapy with polyarticular, culture-negative septic arthritis. She underwent irrigation and debridement with empiric antibiotic therapy but had recurrence of septic arthritis despite treatment. Polymerase chain reaction testing eventually identified Ureaplasma as the causative organism. She was successfully treated with an extended course of organism-specific antibiotics. CONCLUSION: More patients are being treated with immune modulating therapies. Immunosuppressed patients are at risk for atypical infections and may have different presentations than immunocompetent patients. Newer diagnostic modalities can help identify causative organisms and direct treatment in the case of negative cultures.

Novel use of lip balm under tracheostomy ties to prevent skin irritation in the pediatric patient.

OBJECTIVES: To study the effectiveness of lip balm in reducing skin irritation and preventing pressure induced injury in tracheostomy dependent children. METHODS: The skin of tracheostomy patients presenting to a pediatric otolaryngology clinic over a 12 month period from 2018 to 2019 was assessed and categorized as hyperemic blanchable (abnormal pre-pressure injury), hyperemic non-blanchable, partial thickness skin loss, or full thickness skin loss. Caregivers were instructed to apply lip balm to the skin under soft ties three times per day and with tracheostomy tie changes. Patients were followed prospectively by a tracheostomy care nurse. RESULTS: 24 patients enrolled and reported daily adherence with lip balm use. Median age was 7.3 years (interquartile range, IQR, = 1.3-12.4) with 10 females and 14 males. The majority of patients (n = 20) were identified as having hyperemic blanchable skin. 96% (23/24) of caregivers reported a subjective benefit. 79.2% (95% CI: 57.8%-92.9%) of patients with hyperemic skin (n = 24) demonstrated complete resolution with continued application, and was found to be significant: all patients had skin hyperemia before application, while 20.8% (5/24) continued to have hyperemia after application (P < .001). Infants and ventilation dependent patients demonstrated recovery rates of 88.9% and 75% respectively. Median duration of follow-up was 6.3 months (IQR = 3.4-11.3). There were no documented allergic reactions, accidental decannulations, or skin deterioration in the cohort. CONCLUSIONS: Lip balm appears to be a low cost, hydrophobic, and friction-reducing agent that is potentially useful in preventing at risk pressure injuries in tracheostomy dependent pediatric patients.